Ch. 553

1995 LAWS OF MARYLAND

(2) the requirement under § 15-607(c) of this subtitle of disclosure of all
partnerships, LIMITED LIABILITY PARTNERSHIPS, OR LIMITED LIABILITY COMPANIES
in which the individual holds an interest.

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 1995.

Approved May 25, 1995.

CHAPTER 553
(House Bill 521)

AN ACT concerning

Private Review Agents - Involuntary or Voluntary Inpatient Admissions - Coverage

FOR the purpose of prohibiting a private review agent from rendering an adverse
decision or denying coverage for covered services the patient's physician or
psychologist in conjunction with a certain member of the medical staff at the
hospital consider to be medically necessary as to the admission of a patient under
certain circumstances; requiring a hospital to notify a private review agent regarding a
patient admission; and generally relating to a private review agent's ability to render
an adverse decision or deny coverage under certain circumstances.

BY adding to

Article - Health - General

Section 19-1305.3(e)

Annotated Code of Maryland

(1990 Replacement Volume and 1994 Supplement)

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

Article - Health - General

19-1305.3.

(E) FOR AN INVOLUNTARY OR VOLUNTARY INPATIENT ADMISSION OF A
PATIENT DETERMINED BY THE PATIENT'S PHYSICIAN OR PSYCHOLOGIST IN
CONJUNCTION WITH A MEMBER OF THE MEDICAL STAFF OF THE HOSPITAL WHO
HAS PRIVILEGES TO ADMIT PATIENTS TO BE IN IMMINENT DANGER TO SELF OR
OTHERS, A PRIVATE REVIEW AGENT MAY NOT RENDER AN ADVERSE DECISION OR
DENY COVERAGE FOR COVERED SERVICES THE MEDICAL STAFF OF THE HOSPITAL
CONSIDER TO BE MEDICALLY NECESSARY AS TO THE ADMISSION OF A PATIENT
DURING THE FIRST 24 HOURS THE PATIENT IS IN AN INPATIENT FACILITY OR UNTIL
THE NEXT BUSINESS DAY OF THE PRIVATE REVIEW AGENT, WHICHEVER IS LATER.
THE HOSPITAL SHALL IMMEDIATELY NOTIFY THE PRIVATE REVIEW AGENT THAT A
PATIENT HAS BEEN ADMITTED AND SHALL STATE THE REASONS FOR THE ADMISSION.

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