§ 15-10B-03. Certification of private review agent required to conduct utilization review
West's Annotated Code of MarylandInsurance
MD Code, Insurance, § 15-10B-03
§ 15-10B-03. Certification of private review agent required to conduct utilization review
(a) A private review agent may not conduct utilization review in this State unless the Commissioner has granted the private review agent a certificate.
(b) The Commissioner shall issue a certificate to an applicant that has met all the requirements of this subtitle and all applicable regulations of the Commissioner.
(d) The Commissioner may consider an applicant as having met a particular certification requirement under this subtitle if:
(f) The Commissioner may not issue a certificate to an applicant with utilization management accreditation by an approved accrediting organization unless the applicant meets all the requirements of this subtitle and all applicable regulations of the Commissioner.
(g) A report of an approved accrediting organization used by the Commissioner as evidence that the applicant has met a particular requirement for a private review agent certificate shall be made available by the Commissioner to the public on request.
(h)(1) The Commissioner, after consultation with payors, including the Health Insurance Association of America, the League of Life and Health Insurers of Maryland, and the Maryland Association of Health Plans, and providers of health care, including the MHA: the Association of Maryland Hospitals and Health Systems, CareFirst BlueCross BlueShield, the Medical and Chirurgical Faculty of Maryland, and licensed or certified providers of treatment for a mental illness, emotional disorder, or a drug abuse or alcohol abuse disorder, shall adopt regulations to implement the provisions of this subtitle.
Credits
Added by Acts 1988, c. 703, § 1, eff. Dec. 1, 1988. Amended by Acts 1989, c. 5, § 1, eff. March 9, 1989; Acts 1995, c. 577, § 1, eff. Oct. 1, 1995; Acts 1997, c. 70, § 4, eff. Oct. 1, 1997. Transferred from Health - General § 19-1303 and amended by Acts 1998, c. 111, §§ 1, 2, eff. Jan. 1, 1999; Acts 1998, c. 112, §§ 1, 2, eff. Jan. 1, 1999. Amended by Acts 2000, c. 123, § 1, eff. Jan. 1, 2001; Acts 2001, c. 53, § 1, eff. Jan. 1, 2002; Acts 2003, c. 321, § 1, eff. Oct. 1, 2003.
MD Code, Insurance, § 15-10B-03, MD INSURANCE § 15-10B-03
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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