Ch. 703

LAWS OF MARYLAND

QUALIFICATIONS OF PRIVATE REVIEW AGENTS OR THE PERFORMANCE OF
UTILIZATION REVIEW.

(2) THE SECRETARY SHALL DENY A CERTIFICATE TO ANY
APPLICANT THAT DOES NOT PROVIDE ASSURANCES SATISFACTORY TO THE
SECRETARY THAT:

(I)  THE PROCEDURES AND POLICIES OF THE PRIVATE
REVIEW AGENT WILL PROTECT THE CONFIDENTIALITY OF MEDICAL RECORDS
IN ACCORDANCE WITH APPLICABLE STATE AND FEDERAL LAWS; AND

(II)  THE PRIVATE REVIEW AGENT WILL BE
ACCESSIBLE TO PATIENTS AND PROVIDERS 5 WORKING DAYS A WEEK DURING
NORMAL BUSINESS HOURS IN THIS STATE.

(B)  THE SECRETARY MAY REVOKE A CERTIFICATE IF THE HOLDER
DOES NOT COMPLY WITH PERFORMANCE ASSURANCES UNDER THIS SECTION,
VIOLATES ANY PROVISION OF THIS SUBTITLE, OR VIOLATES ANY
REGULATION ADOPTED UNDER ANY PROVISION OF THIS SUBTITLE.

(C)  (1) BEFORE DENYING OR REVOKING A CERTIFICATE UNDER THIS
SECTION, THE SECRETARY SHALL PROVIDE THE APPLICANT OR CERTIFICATE
HOLDER WITH REASONABLE TIME TO SUPPLY ADDITIONAL INFORMATION
DEMONSTRATING COMPLIANCE WITH THE REQUIREMENTS OF THIS SUBTITLE
AND THE OPPORTUNITY TO REQUEST A HEARING.

(2)  IF AN APPLICANT OR CERTIFICATE HOLDER REQUESTS A
HEARING, THE SECRETARY SHALL SEND A HEARING NOTICE BY CERTIFIED
MAIL, RETURN RECEIPT REQUESTED, AT LEAST 30 DAYS BEFORE THE
HEARING.

(3)  THE SECRETARY SHALL HOLD THE HEARING IN
ACCORDANCE WITH TITLE 10, SUBTITLE 2 OF THE STATE GOVERNMENT
ARTICLE.

19-1308.

THE SECRETARY MAY WAIVE THE REQUIREMENTS OF THIS SUBTITLE
FOR A PRIVATE REVIEW AGENT THAT OPERATES SOLELY UNDER CONTRACT
WITH THE FEDERAL GOVERNMENT FOR UTILIZATION REVIEW OF PATIENTS
ELIGIBLE FOR HOSPITAL SERVICES UNDER TITLE XVIII OF THE SOCIAL
SECURITY ACT.

19-1309.

THE SECRETARY SHALL PERIODICALLY PROVIDE A LIST OF PRIVATE
REVIEW AGENTS ISSUED CERTIFICATES AND THE RENEWAL DATE FOR THOSE
CERTIFICATES TO:

(1)  THE MARYLAND CHAMBER OF COMMERCE;

(2)  THE MEDICAL AND CHIRURGICAL FACULTY OF MARYLAND;

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