HARRY HUGHES, Governor

747

The only changes are in style.

Defined terms: "Department" § 1-101
"Program" § 15-101

15-108. FIELD VERIFICATION OF PROGRAM PARTICIPANTS.

(A)  "BOARD" DEFINED.

IN THIS SECTION, "BOARD" MEANS AN APPEAL BOARD
ESTABLISHED UNDER THIS SECTION.

(B)  APPOINTMENT OF BOARD.

(1) THE SECRETARY MAY:

(I) ESTABLISH ONE OR MORE BOARDS FOR
PURPOSES OF THIS SECTION; AND

BOARD.

AND

MEMBERS.

(II) DESIGNATE THE JURISDICTION OF A

(2) A BOARD SHALL CONSIST OF 3 MEMBERS.
(3) OF THE 3 BOARD MEMBERS:

(I)  2 SHALL BE APPOINTED BY THE SECRETARY;

(II)  1 SHALL BE CHOSEN BY THE APPOINTED
(4) OF THE 2 APPOINTED MEMBERS OF A BOARD:

(I)  1 SHALL BE A REPRESENTATIVE OF THE
INDUSTRY AFFECTED WHO IS AN INDIVIDUAL KNOWLEDGEABLE IN
MEDICARE AND MEDICAID REIMBURSEMENT PRINCIPLES; AND

(II)  1 SHALL BE AN INDIVIDUAL WHO IS
EMPLOYED BY THIS STATE AND KNOWLEDGEABLE IN MEDICARE AND
MEDICAID REIMBURSEMENT PRINCIPLES AND WHO DOES NOT
PARTICIPATE DIRECTLY IN THE FIELD VERIFICATIONS.

(C) NOTICE OF RESULTS.

IF THE DEPARTMENT OR AN AGENT OF THE DEPARTMENT DOES A
FIELD VERIFICATION OF THE COSTS AND ALLOWABLE CHARGES OF A
HOSPITAL, INTERMEDIATE CARE FACILITY, OR SKILLED NURSING
FACILITY THAT PARTICIPATES IN THE PROGRAM, THE DEPARTMENT OR
AGENT SHALL NOTIFY THE HOSPITAL OR FACILITY OF THE RESULTS
OF THE FIELD VERIFICATION.

(D) APPEAL OF RESULTS.