Ch. 605

1995 LAWS OF MARYLAND

(1) UPON REQUEST, PROVIDE AN APPLICATION, AND INFORMATION
RELATIVE TO CONSIDERATION FOR PARTICIPATION IN THE CARRIER'S PROVIDER
PANEL, TO ANY PROVIDER WISHING TO APPLY FOR PARTICIPATION IN THE
CARRIER'S PROVIDER PANEL;

(2) MAKE PUBLICLY AVAILABLE ITS APPLICATION; AND

(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.

(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 TO THE ADDRESS LISTED ON
THE APPLICATION.

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

(II) FAILURE OF THE CARRIER TO SEND NOTIFICATION IN
ACCORDANCE WITH SUBPARAGRAPH (I) 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.

(III) A CARRIER THAT GIVES NOTICE OF REJECTION OF A
PROVIDER'S APPLICATION FOR PARTICIPATION IN THE CARRIER'S PROVIDER PANEL
SHALL INFORM THE PROVIDER IN WRITING OF THE REASON FOR REJECTING THE
APPLICATION.

(IV) IF A CARRIER DEMONSTRATES THAT IT IS IN COMPLIANCE
WITH § 19-705.1 OF THE HEALTH GENERAL ARTICLE, A CARRIER MAY REJECT AN
APPLICATION FOR PARTICIPATION IN THE CARRIER'S PROVIDER PANEL BASED
SOLELY ON THE PARTICIPATION IN THE CARRIER'S PROVIDER PANEL OF A
SUFFICIENT NUMBER OF SIMILARLY QUALIFIED PROVIDERS THAT PERFORM
SIMILAR SERVICES.

(4) (I) A CARRIER THAT RECEIVES AN INCOMPLETE APPLICATION
SUBMITTED IN ACCORDANCE WITH PARAGRAPH (1) 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

- 3460 -