Subtitle 10b—Private Review Agents

• MD Insurance T. 15, Subt. 10b, Refs & Annos
• § 15–10b–01. Definitions
• § 15–10b–02. Purpose of Subtitle
• § 15–10b–03. Certification of Private Review Agent Required to Conduct Utilization Review
• § 15–10b–04. Certificate Application
• § 15–10b–05. Utilization Review Plan Requirements
• § 15–10b–06. Determinations Relating to Treatment and Health Care Services
• § 15–10b–07. Adverse Decisions and Appeals
• § 15–10b–08. Internal Grievance Process for Patients and Health Care Providers
• § 15–10b–09. Review of Hospital Services Related to Maternity and Newborn Care
• § 15–10b–09.1. Grievance Decisions
• § 15–10b–10. Renewal and Expiration of Certificate
• § 15–10b–11. Prohibited Actions by Private Review Agents
• § 15–10b–12. Discipline for Violation of Subtitle
• § 15–10b–13. Right to Hearing and Appeal
• § 15–10b–14. Waiver of Requirements for Private Review Agent
• § 15–10b–15. List of Private Review Agents Issued Certificates
• § 15–10b–16. Reporting Requirements
• § 15–10b–17. Patient Referral Requirements
• § 15–10b–18. Intention of Private Review Agent to Withdraw Certificate
• § 15–10b–19. Examination of Private Review Agents
• § 15–10b–20. Examination of Pharmacy Benefit Managers Registered as Private Review Agents