WILLIAM DONALD SCHAEFER, Governor Ch. 703

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.

19-1303.

(A)  A PRIVATE REVIEW AGENT MAY NOT CONDUCT UTILIZATION
REVIEW IN THIS STATE UNLESS THE SECRETARY HAS GRANTED THE PRIVATE
REVIEW AGENT A CERTIFICATE.

(B)  THE SECRETARY SHALL ISSUE A CERTIFICATE TO AN APPLICANT
THAT HAS MET ALL THE REQUIREMENTS OF THIS SUBTITLE AND ALL
APPLICABLE REGULATIONS OF THE SECRETARY.

(C)  THE SECRETARY MAY DELEGATE THE AUTHORITY TO ISSUE A
CERTIFICATE TO THE COMMISSIONER FOR ANY HEALTH INSURER OR
NONPROFIT HEALTH SERVICE PLAN REGULATED UNDER ARTICLE 48A OF THE
CODE OR HEALTH MAINTENANCE ORGANIZATION ISSUED A CERTIFICATE OF
AUTHORITY IN ACCORDANCE WITH SUBTITLE 7 OF THIS TITLE THAT MEETS
THE REQUIREMENTS OF THIS SUBTITLE AND ALL APPLICABLE REGULATIONS
OF THE SECRETARY.

(D)  A CERTIFICATE ISSUED UNDER THIS SUBTITLE IS NOT
TRANSFERABLE.

(E)  THE SECRETARY, AFTER CONSULTATION WITH THE
COMMISSIONER, PAYORS, INCLUDING THE HEALTH INSURANCE ASSOCIATION
OF AMERICA AND THE MARYLAND ASSOCIATION OF HEALTH MAINTENANCE
ORGANIZATIONS, AND PROVIDERS, INCLUDING THE MARYLAND HOSPITAL
ASSOCIATION, OF HEALTH CARE, SHALL ADOPT REGULATIONS TO IMPLEMENT
THE PROVISIONS OF THIS SUBTITLE.

19-1304.

(A)  AN APPLICANT FOR A CERTIFICATE SHALL:

(1)  SUBMIT AN APPLICATION TO THE SECRETARY; AND

(2)  PAY TO THE SECRETARY THE APPLICATION FEE
ESTABLISHED BY THE SECRETARY THROUGH REGULATION.

(B)  THE APPLICATION SHALL:

(1)  BE ON A FORM AND ACCOMPANIED BY ANY SUPPORTING
DOCUMENTATION THAT THE SECRETARY REQUIRES; AND

(2)  BE SIGNED AND VERIFIED BY THE APPLICANT.

(C)  THE APPLICATION FEE SHALL BE REASONABLE AND NOT EXCEED
FEES REQUIRED UNDER SUBSECTION (A)(2) OF THIS SECTION OR §

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