Ch. 352                                    1996 LAWS OF MARYLAND

(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 carrier's provider panel by a sufficient number of
similarly qualified providers.

(3)    A violation of this subsection does not create a new cause of action.

(g) Each carrier shall establish an internal review system to resolve any grievances
initiated by providers that are participating in the carrier's provider panel including grievances
involving the termination of a provider from participation in the carrier's provider panel.

(h) A carrier may not terminate a provider from participation in the carrier's provider
panel or otherwise penalize a provider, for:

(1)    Advocating the interest of a patient through the carrier's internal review
system; or

(2)    Filing an appeal under the provisions of Title 19, Subtitle '13 of the Health -
General Article.                                           

(i) (1) A carrier shall provide to a new member prior to enrollment and to existing
enrollees at least once a year:

(i) A list of providers in its provider panel; and

(ii) Information with respect to providers who are no longer accepting new
patients.

(2)     The information provided under paragraph (1) of this subsection shall be
updated at least once a year.

(3)     The evidence of coverage, policy, or certificate shall:

(i) Clearly indicate the office within the Administration that is responsible
for receiving and responding to enrollee's complaints concerning carriers; and

(ii) Include the telephone number of the office and the process for filing a
complaint

(j) (1) For a period of at least 90 days from the date of the notice of a primary care
provider's termination from the carrier's provider panel for reasons unrelated to fraud, patient
abuse, incompetency, or loss of licensure status by the primary care provider, the primary care
provider shall render health care services to any of the carrier's enrollees who:

(i) Were receiving health care services from the primary care provider
prior to the notice of termination; and

(ii) Request, after receiving notice of the primary care provider's
termination under subsection (b) of this section, to continue receiving health care services from
the primary care provider.

(2) A carrier shall reimburse the primary care provider under this subsection in
accordance with the provider's agreement with the carrier.

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