HARRY HUGHES, Governor

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S. C. § 1396 et seq. (1970 Ed. and Supp. III 1972), as
amended from time to time, AND PUBLIC HEALTH SERVICE ACT,
TITLE III (42 U.S.C. § 254C), AS AMENDED FROM TIME TO TIME,
the professional standards review organization, consistent
with the certification of the Secretary of the United States
Department of Health, Education and Welfare, is authorized
to review health and medical services of the health
maintenance organizations;

(8)   With the approval of the Department of
Health and Mental Hygiene, the organization has provided for
an internal peer review which will provide for continuous
monitoring and evaluation of patient records for quality of
care and for over—utilization and under—utilization of
provider care;

(9)   The organization has provided an internal
grievance system to resolve adequately any grievances
initiated by any of its HEALTH MAINTENANCE ORGANIZATION
members, in a manner approved by the Department of Health
and Mental Hygiene on matters concerning quality of care and
by the Commissioner on financial matters, in accordance with
joint internal administrative rules and procedures;

(10)   Procedures are established to offer all
members an opportunity to participate in matters of policy
and operation; and

(11)   The HEALTH MAINTENANCE organization will
maintain a health and medical records system which is
readily accessible by duly authorized persons under
procedures assuring maximum confidentiality and which is
adequate to provide an accurate documentation of utilization
for every member. The health and medical records system
shall clearly identify, at a minimum, each patient by name,
number, age and sex, and to indicate clearly:

(i) The services provided;

(ii) When the services were provided;

(iii) Where the services were provided;

(iv) By whom the services were provided;

(v) The diagnosis and prognosis, if

appropriate;

appropriate.

(vi) The treatment;

(vii) Any drug therapy; and

(viii) The patient's health status, if

(b) The Commissioner may, in accordance with
regulations, permit fan] A HEALTH MAINTENANCE organization