What is the legal framework for the formation of health care groups?

In Maryland, health care groups are regulated by a legal framework that is based on state and federal laws. This framework, which was created in response to the increasing complexity of health care in the state, is designed to protect the public interest while promoting access to high quality, affordable health care. At the state level, the Maryland Medical Care Programs Act (MMCP) is the primary governing body for health care groups. It sets the standards for the provision of medical services, as well as the types of practices that are allowed. The Act also establishes guidelines for the formation of health care groups and for their membership requirements. For instance, a health care group must have at least three providers, and all providers must be licensed in Maryland. It also establishes regulatory policies and procedures for dispute resolution and financial management. At the federal level, the Affordable Care Act (ACA) establishes the framework for the formation of health care groups and sets standards for the provision of services within those groups. This includes qualifications for providers, policies related to the delivery of services, and procedures for enforcement of those policies. It also outlines requirements for coverage, such as essential health benefits, and cost-sharing arrangements. Taken together, these laws provide the legal framework for the formation of health care groups in Maryland. By setting clear and consistent standards, these laws help ensure that Maryland residents receive quality, affordable health care.

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What is the legal framework for the formation of health care groups?

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