Ch. 604                                        1995 LAWS OF MARYLAND

(3) MAKE EFFORTS TO INCREASE THE OPPORTUNITY OF A BROAD
RANGE OF MINORITY PROVIDERS TO PARTICIPATE IN THE CARRIER'S PROVIDER
PANEL.

(D) (1) A PROVIDER SEEKING PARTICIPATION IN THE PROVIDER PANEL OF
A CARRIER SHALL SUBMIT AN APPLICATION TO THE CARRIER BY REGISTERED OR
CERTIFIED MAIL WITH RETURN RECEIPT REQUESTED.

(2) (I) AFTER REVIEW BY A CARRIER OF AN APPLICATION
SUBMITTED UNDER PARAGRAPH (1) OF THIS SUBSECTION, THE CARRIER SHALL
ACCEPT OR, SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION, REJECT THE
PROVIDER FOR PARTICIPATION IN THE CARRIER'S PROVIDER PANEL.
(II) IF THE CARRIER REJECTS THE PROVIDER FOR PARTICIPATION
IN THE CARRIER'S PROVIDER PANEL, THE CARRIER SHALL SEND WRITTEN
NOTIFICATION OF THE REJECTION TO THE PROVIDER BY REGISTERED OR
CERTIFIED MAIL WITH RETURN RECEIPT REQUESTED TO THE ADDRESS LISTED ON
THE APPLICATION.

(3) (I) EXCEPT AS PROVIDED IN PARAGRAPH (4) OF THIS SUBSECTION;
A CARRIER SHALL GIVE NOTICE OF A PROVIDER'S ACCEPTANCE OR REJECTION OF
AN APPLICATION FOR PARTICIPATION IN THE CARRIER'S PROVIDER PANEL WITHIN
60 DAYS AFTER RECEIPT BY THE CARRIER OF THE COMPLETED APPLICATION.

(II) IF A CARRIER DOES NOT NOTIFY THE PROVIDER OF THE
PROVIDER'S ACCEPTANCE OR REJECTION FOR PARTICIPATION IN THE CARRIER'S
PROVIDER PANEL WITHIN 60 DAYS OF RECEIPT OF THE COMPLETED APPLICATION:

1. THE PROVIDER SHALL BE DEEMED TO HAVE BEEN
ACCEPTED BY THE CARRIER IN THE CARRIER'S PROVIDER PANEL AND, EXCEPT FOR
A PROVIDER WHO IS SEEKING TO BE AN EMPLOYEE IN THE CARRIER'S PROVIDER
PANEL, SHALL BE REIMBURSED FOR HEALTH CARE SERVICES RENDERED TO
ENROLLEES IN ACCORDANCE WITH THE TERMS AND CONDITIONS THE CARRIER
HAS EXECUTED WITH PROVIDERS IN ITS PROVIDER PANEL FOR SIMILAR SERVICES
IN THE SAME GEOGRAPHIC AREA; AND

2. THE CARRIER SHALL SEND TO THE PROVIDER BY
REGISTERED OR CERTIFIED MAIL WITH RETURN RECEIPT REQUESTED TO THE
ADDRESS LISTED ON THE APPLICATION OF THE PROVIDER A PROVIDER
AGREEMENT OR CONTRACT FOR THE PROVIDER'S SIGNATURE.

(III) FAILURE OF THE CARRIER TO SEND THE APPLICATION IN
ACCORDANCE WITH SUBPARAGRAPH (II) OF THIS PARAGRAPH SHALL BE
CONSIDERED A VIOLATION OF THIS ARTICLE AND THE CARRIER IS SUBJECT TO THE
PROVISIONS AND PENALTIES OF §§ 55 AND 55A OF THIS ARTICLE.

(4) (I) A CARRIER THAT RECEIVES AN INCOMPLETE APPLICATION
SUBMITTED IN ACCORDANCE WITH PARAGRAPH (1) OF THIS SUBSECTION MAY
RETURN THE APPLICATION WITHIN 10 DAYS FROM THE DATE OF RECEIPT TO THE
PROVIDER BY REGISTERED OR CERTIFIED MAIL WITH RETURN RECEIPT
REQUESTED TO THE ADDRESS LISTED ON THE APPLICATION:

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