|
|
|
|
|
|
|
|
|
|
|
|
|
ROBERT L. EHRLICH, JR., Governor Ch. 54
(iv) The failure of a carrier to provide the notice required under
subparagraph (iii)2 of this paragraph is a violation of this article and the carrier is
subject to the provisions of and penalties provided by §§ 4-113 and 4-114 of this
article.
(4) (i) A carrier that receives an incomplete application shall return
the application to the provider at the address listed in the application within 10 days
after the date the application is received.
(ii) The carrier shall indicate to the provider what information is
needed to make the application complete.
(iii) The provider may return the completed application to the
carrier.
(iv) After the carrier receives the completed application, the carrier
is subject to the time periods established in paragraph (3) of this subsection.
(5) A carrier may charge a reasonable fee for an application submitted to
the carrier under this section.
(F-1) (1) SUBJECT TO THE PROVISIONS OF THIS SUBSECTION, A CARRIER MAY
NOT REQUIRE A PROVIDER PARTICIPATING ON ITS PROVIDER PANEL TO BE
RECREDENTIALED BASED ON:
(I) A CHANGE IN THE FEDERAL TAX IDENTIFICATION NUMBER OF
THE PROVIDER;
(II) A CHANGE IN THE FEDERAL TAX IDENTIFICATION NUMBER OF
A PROVIDER'S EMPLOYER; OR
(III) A CHANGE IN THE EMPLOYER OF A PROVIDER, IF THE NEW
EMPLOYER IS:
1. A PARTICIPATING PROVIDER ON THE CARRIER'S
PROVIDER PANEL; OR
2. THE EMPLOYER OF PROVIDERS THAT PARTICIPATE ON
THE CARRIER'S PROVIDER PANEL.
(2) A PROVIDER THAT PARTICIPATES ON A CARRIER'S PROVIDER PANEL
OR THE PROVIDER'S EMPLOYER SHALL GIVE WRITTEN NOTICE TO THE CARRIER OF A
CHANGE IN THE FEDERAL TAX IDENTIFICATION NUMBER OF THE PROVIDER OR THE
PROVIDER'S EMPLOYER NOT LESS THAN 45 DAYS BEFORE THE EFFECTIVE DATE OF
THE CHANGE.
(3) THE NOTICE REQUIRED UNDER PARAGRAPH (2) OF THIS SUBSECTION
SHALL INCLUDE:
(I) A STATEMENT OF THE INTENTION OF THE PROVIDER OR THE
PROVIDER'S EMPLOYER TO CONTINUE TO PROVIDE HEALTH CARE SERVICES IN THE
SAME FIELD OF SPECIALIZATION, IF APPLICABLE;
- 365 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
