Maryland Code, HEALTH – GENERAL 19-730
Terms Used In Maryland Code, HEALTH - GENERAL 19-730
- Contract: A legal written agreement that becomes binding when signed.
- Equitable: Pertaining to civil suits in "equity" rather than in "law." In English legal history, the courts of "law" could order the payment of damages and could afford no other remedy. See damages. A separate court of "equity" could order someone to do something or to cease to do something. See, e.g., injunction. In American jurisprudence, the federal courts have both legal and equitable power, but the distinction is still an important one. For example, a trial by jury is normally available in "law" cases but not in "equity" cases. Source: U.S. Courts
- Person: includes an individual, receiver, trustee, guardian, personal representative, fiduciary, representative of any kind, corporation, partnership, business trust, statutory trust, limited liability company, firm, association, or other nongovernmental entity. See
- Restitution: The court-ordered payment of money by the defendant to the victim for damages caused by the criminal action.
(1) Issue an administrative order that requires the health maintenance organization to:
(i) Cease inappropriate conduct or practices by it or any of the personnel employed or associated with it;
(ii) Fulfill its contractual obligations;
(iii) Provide a service that has been denied improperly;
(iv) Take appropriate steps to restore its ability to provide a service that is provided under a contract;
(v) Cease the enrollment of any additional enrollees except newborn children or other newly acquired dependents of existing enrollees; or
(vi) Cease any advertising or solicitation;
(2) In addition to suspending or revoking a certificate of authority:
(i) Impose a penalty of not less than $100, but not more than $125,000 for each violation; and
(ii) Order the health maintenance organization to pay restitution to any person who has suffered financial injury because of the violation;
(3) Suspend, revoke, or refuse to renew the certificate of authority to do business as a health maintenance organization;
(4) Suspend, revoke, or refuse to renew the certificate of a medical director of a health maintenance organization; or
(5) Apply to any court for legal or equitable relief considered appropriate by the Commissioner or the Department, in accordance with the joint internal procedures.
(b) If the Commissioner issues an order or imposes any penalty under this section, the Commissioner immediately shall provide written notice of the order or penalty to the Secretary.