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Session Laws, 1997
Volume 795, Page 955   View pdf image
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PARRIS N. GLENDENING, Governor

Ch. 35

(C) AVAILABILITY OF APPLICATION AND INFORMATION.
A CARRIER THAT USES A PROVIDER PANEL:

(1) ON REQUEST, SHALL PROVIDE AN APPLICATION AND INFORMATION
THAT RELATES TO CONSIDERATION FOR PARTICIPATION ON THE CARRIER'S
PROVIDER PANEL TO ANY PROVIDER SEEKING TO APPLY FOR PARTICIPATION;

(2) SHALL MAKE PUBLICLY AVAILABLE ITS APPLICATION; AND

(3) SHALL MAKE EFFORTS TO INCREASE THE OPPORTUNITY FOR A
BROAD RANGE OF MINORITY PROVIDERS TO PARTICIPATE ON THE CARRIER'S
PROVIDER PANEL.

(D) APPLICATION PROCEDURE.

(1) A PROVIDER THAT SEEKS TO PARTICIPATE ON A PROVIDER PANEL
OF A CARRIER SHALL SUBMIT AN APPLICATION TO THE CARRIER,

(2) (I) SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION, THE
CARRIER, AFTER REVIEWING THE APPLICATION, SHALL ACCEPT OR REJECT THE
PROVIDER FOR PARTICIPATION ON THE CARRIER'S PROVIDER PANEL.

(II) IF THE CARRIER REJECTS THE PROVIDER FOR PARTICIPATION
ON THE CARRIER'S PROVIDER PANEL, THE CARRIER SHALL SEND TO THE PROVIDER
AT THE ADDRESS LISTED IN THE APPLICATION WRITTEN NOTICE OF THE
REJECTION.

(3) (I) EXCEPT AS PROVIDED IN PARAGRAPH (4) OF THIS SUBSECTION,
WITHIN 30 DAYS AFTER THE DATE A CARRIER RECEIVES A COMPLETED
APPLICATION, THE CARRIER SHALL SEND TO THE PROVIDER AT THE ADDRESS
LISTED IN THE APPLICATION WRITTEN NOTICE OF:

1. THE CARRIER'S INTENT TO CONTINUE TO PROCESS THE
PROVIDER'S APPLICATION TO OBTAIN NECESSARY CREDENTIALING INFORMATION;
OR

2. THE CARRIER'S REJECTION OF THE PROVIDER FOR
PARTICIPATION ON THE CARRIER'S PROVIDER PANEL.

(II) THE FAILURE OF A CARRIER TO PROVIDE THE NOTICE
REQUIRED UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH IS A VIOLATION OF
THIS ARTICLE AND THE CARRIER IS SUBJECT TO THE PENALTIES PROVIDED BY §
4-113(D) OF THIS ARTICLE.

(III) IF, UNDER SUBPARAGRAPH (I)1 OF THIS PARAGRAPH, A
CARRIER PROVIDES NOTICE TO THE PROVIDER OF ITS INTENT TO CONTINUE TO
PROCESS THE PROVIDER'S APPLICATION TO OBTAIN NECESSARY CREDENTIALING
INFORMATION, THE CARRIER, WITHIN 150 DAYS AFTER THE DATE THE NOTICE IS
PROVIDED, SHALL:

1. ACCEPT OR REJECT THE PROVIDER FOR PARTICIPATION
ON THE CARRIER'S PROVIDER PANEL; AND

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Session Laws, 1997
Volume 795, Page 955   View pdf image
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