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Ch. 123
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2000 LAWS OF MARYLAND
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15-10B-02.
The purpose of this subtitle is to:
(1) promote the delivery of quality health care in a cost effective manner;
(2) foster greater coordination between payors and providers conducting
utilization review activities;
(3) protect patients, business, and providers by ensuring that private
review agents are qualified to perform utilization review activities and to make
informed decisions on the appropriateness of medical care; and
(4) ensure that private review agents maintain the confidentiality of
medical records in accordance with applicable State and federal laws.
15-10B-03.
(d) (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 [Maintenance Organizations]
PLANS, and providers of health care, including the [Maryland Hospital Association]
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.
(2) (i) Subject to the provisions of subparagraph (iii) of this paragraph,
the regulations adopted by the Commissioner shall include a uniform treatment plan
form for utilization review of services for the treatment of a mental illness, emotional
disorder, or a drug abuse or alcohol abuse disorder.
(ii) The uniform treatment plan form adopted by the
Commissioner:
1. shall adequately protect the confidentiality of the patient;
and
2. may only request the patient's membership number, policy
number, or other similar unique patient identifier and first name for patient
identification.
(iii) The Commissioner may waive the requirements of regulations
adopted under subparagraph (i) of this paragraph for the use of a uniform treatment
plan form for any entity that would be using the form solely for internal purposes.
15-10B-04.
(a) An applicant for a certificate shall:
(1) submit an application to the Commissioner; and
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