Ch. 604

1995 LAWS OF MARYLAND

2. SEND WRITTEN NOTIFICATION TO THE ADDRESS LISTED ON
THE APPLICATION OF THE PROVIDER'S ACCEPTANCE OR REJECTION FOR PARTICIPATION
IN THE CARRIER'S PROVIDER PANEL.

(IV) FAILURE OF A CARRIER TO SEND THE WRITTEN NOTIFICATION
REQUIRED UNDER SUBPARAGRAPH (III) 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 (I) OF THIS SUBSECTION SHALL RETURN
THE APPLICATION WITHIN 10 DAYS FROM THE DATE OF RECEIPT TO THE PROVIDER TO
THE ADDRESS LISTED ON THE APPLICATION.

(II)     THE CARRIER SHALL INDICATE TO THE PROVIDER WHAT
INFORMATION IS NEEDED IN ORDER TO MAKE THE APPLICATION COMPLETE.

(III)    THE PROVIDER MAY RETURN THE COMPLETED APPLICATION TO
THE CARRIER.

(IV)    AFTER THE CARRIER RECEIVES THE COMPLETED APPLICATION,
THE CARRIER IS SUBJECT TO THE TIME PERIODS ESTABLISHED IN PARAGRAPH (3) OF
THIS SUBSECTION.

(5) A CARRIER MAY CHARGE A REASONABLE FEE FOR ANY APPLICATION
THAT A PROVIDER SUBMITS TO THE CARRIER UNDER THIS SECTION.

(E) A CARRIER MAY NOT DENY AN APPLICATION FOR PARTICIPATION OR
TERMINATE PARTICIPATION ON ITS PROVIDER PANEL ON THE BASIS OF:

(1) GENDER, RACE, AGE, RELIGION, NATIONAL ORIGIN, OR A
PROTECTED CATEGORY UNDER THE AMERICANS WITH DISABILITIES ACT;

(2) THE TYPE OR NUMBER OF APPEALS FILED BY THE PROVIDER
UNDER THE PROVISIONS OF TITLE 19, SUBTITLE 13 OF THE HEALTH - GENERAL
ARTICLE; OR

(3) ANY OTHER COMPLAINT OR GRIEVANCE, OR THE TYPE OR THE
NUMBER OF COMPLAINTS OR GRIEVANCES, THE PROVIDER FILED OR REQUESTED
FOR REVIEW UNDER THE CARRIER'S INTERNAL REVIEW SYSTEM.

(F) (1) A CARRIER MAY NOT DENY AN APPLICATION FOR PARTICIPATION OR
TERMINATE PARTICIPATION ON ITS PROVIDER PANEL SOLELY ON THE BASIS OF THE
LICENSE, CERTIFICATION, OR OTHER AUTHORIZATION OF THE PROVIDER TO PROVIDE
SERVICES IF THE CARRIER PROVIDES SERVICES WITHIN THE PROVIDER'S LAWFUL SCOPE
OF PRACTICE.

(2) NOTWITHSTANDING THE PROVISIONS OF PARAGRAPH (1) OF. THIS
SUBSECTION, A CARRIER MAY REJECT AN APPLICATION FOR PARTICIPATION OR
TERMINATE PARTICIPATION ON THE CARRIER'S PROVIDER PANEL BASED ON THE
PARTICIPATION ON THE PROVIDER'S PANEL BY A SUFFICIENT NUMBER OF SIMILARLY.
QUALIFIED PROVIDERS.

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