Ch. 378

1996 LAWS OF MARYLAND

(II) ONGOING DIALOGUE WITH EXPERTS IN THE LOCAL MEDICAL
COMMUNITY FOR THE PURPOSE OF EVALUATING WHETHER NEW MEDICAL OR
SURGICAL TREATMENTS HAVE BECOME AN APPROPRIATE STANDARD OF CARE FOR
SPECIFIED HUMAN DISEASES OR DISORDERS.

(3) (I) THE CARRIER SHALL IDENTIFY LEADING LOCAL CLINICAL
EXPERTS IN RECOGNIZED MEDICAL AND SURGICAL SPECIALTIES AND
SUBSPECIALTIES FOR THE PURPOSE OF HAVING THE CLINICAL EXPERTS PROVIDE
THE CARRIER WITH DIALOGUE ON AND ANALYSES OF THE STATUS OF EMERGING
MEDICAL AND SURGICAL TREATMENTS.

(II) THE CLINICAL EXPERTS SHALL BE DRAWN FROM:

1. THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE;

2. THE JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE;

3. THE NATIONAL INSTITUTES OF HEALTH;

4. LOCAL PROVIDERS WHO ARE GENERALLY RECOGNIZED
AS AUTHORITATIVE RESOURCES ON CERTAIN HUMAN DISEASES AND DISORDERS;

AND

5. LOCAL CHAPTERS OF MEDICAL AND SURGICAL
SPECIALTY SOCIETIES AND PROFESSIONAL ASSOCIATIONS, AS RECOGNIZED BY THE
AMERICAN BOARD OF MEDICAL SPECIALTIES AND THE U.S. COUNCIL ON MEDICAL
SPECIALTIES.

(4)     THE LOCAL CONICAL EXPERTS IDENTIFIED BY THE CARRIER SHALL
BE:

(4) ACTIVELY INVOLVED IN THE PROVISION OF DIRECT HEALTH
CARE SERVICES TO PATIENTS WITH THE HUMAN DISEASES OR DISORDERS BEING
EVALUATED WHETHER OR NOT THE PATIENTS ROUTINELY TREATED BY THE
PROVIDER ARE ENROLLEES OF THE CARRIER;

(II) BOARD-CERTIFIED IN THE PERTINENT OR APPROPRIATE
SPECIALTY OR SUBSPECIALTY AREA; AND

(III) GENERALLY RECOGNIZES BY THEIR PEERS TO BE
AUTHORITATIVE RESOURCES IN THE CLINICAL AREA BEING EVALUATED, AS
EVIDENCED BY FACULTY APPOINTMENTS, AUTHORSHIP OF A SIGNIFICANT BODY OF
PEER REVIEWED CLINICAL LITERATURE IN THE RELEVANT SPECIALTY AREA, AND
A DEMONSTRATED HISTORY OF LEADERSHIP IN LOCAL, STATE, AND NATIONAL
PROFESSIONAL ASSOCIATIONS AND NONPROFIT PATIENT AND COMMUNITY
ADVOCACY ORGANIZATIONS THAT ADDRESS THE DISEASES AND SPECIALTY AREAS
IN QUESTION.

(5)     THE CARRIER SHALL IDENTIFY THE LOCAL CLINICAL EXPERTS
WITH WHOM IT CONSULTS:

(I) UPON THE REQUEST OF AN ENROLLEE, PROVIDER, OR STATE
OFFICIAL; AND

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