1538

LAWS OF MARYLAND

Ch. 111

WHEREAS, Research demonstrates wide variations in patterns
of medical practice, which cannot be explained by differences in
the health of the population; and

WHEREAS, Research does not identify the appropriate use of
various procedures within a given population, rather it points to
a general lack of consensus within the medical community as to
the proper course of treatment for a large number of diagnoses;
and

WHEREAS, In view of the general lack of consensus within the
medical community on the use of various procedures, there should
be an effective utilization review program applicable to all
hospital patients; and

WHEREAS, The costs of unnecessary care are borne to some
extent by all payors, and therefore it is in the public interest
to prevent the delivery of unnecessary hospital services; now,
therefore,

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:

Article - Health - General

19-319.

(D) (1) AS A CONDITION OF LICENSURE, AS A CONDITION OF
LICENSURE, EACH HOSPITAL SHALL ESTABLISH A UTILIZATION REVIEW
PROGRAM FOR ALL PATIENTS ADMITTED TO THE HOSPITAL. THE
UTILIZATION REVIEW PROGRAM:

(I) SHALL BE APPROVED AND RECERTIFIED

PERIODICALLY BY THE SECRETARY AND IF IT MEETS THE MINIMUM
STANDARDS ESTABLISHED UNDER PARAGRAPH (3) OF THIS SUBSECTION; AND

(II) (I) MAY BE CONDUCTED BY. AN INDEPENDENT,
NONHOSPITAL AFFILIATED REVIEW AGENT:;

(II) SHALL BE PERFORMED BY REGISTERED NURSES,
MEDICAL RECORDS TECHNICIANS, OR SIMILAR QUALIFIED PERSONNEL
SUPPORTED AND SUPERVISED BY PHYSICIANS AS MAY BE REQUIRED; AND

(III) SHALL BE APPROVED AND RECERTIFIED AT
LEAST EVERY -3- 2 YEARS BY THE SECRETARY IF IT MEETS THE MINIMUM
STANDARDS ESTABLISHED UNDER PARAGRAPH (3) OF THIS SUBSECTION.

(2) IF A HOSPITAL FAILS TO PROVIDE THE UTILIZATION
REVIEW PROGRAM REQUIRED UNDER THIS SUBSECTION, THE SECRETARY MAY
IMPOSE THE FOLLOWING PENALTIES: