Ch. 378                                    1996 LAWS OF MARYLAND '"'

(III) FOR EACH DIAGNOSTIC OR THERAPEUTIC SERVICE, A
SUMMARY OF THE OPINIONS OF THE LOCAL CLINICAL EXPERTS ON WHETHER THE
DIAGNOSTIC OR THERAPEUTIC SERVICE IS CONSIDERED A STANDARD OF CARE FOR
THE LOCAL COMMUNITY;

(IV) THE NAMES AND AFFILIATIONS OF EACH LOCAL CLINICAL
EXPERT WHO WORKED WITH THE CARRIER TO EVALUATE THE DIAGNOSTIC OR
THERAPEUTIC SERVICE AND THE FEES OR HONORARIA, IF ANY, THE EXPERT WAS

PAID;

(V) THE NAMES AND TITLES OF EACH OF THE CARRIERS
EMPLOYEES WHO EVALUATE EMERGING MEDICAL AND SURGICAL TREATMENTS TO
DETERMINE WHETHER THESE SERVICES OR PROCEDURES SHOULD BE COVERED
AND PAID FOR BY THE CARRIER;

(VI) THE NAMES AND AFFILIATIONS OF ANY OUTSIDE
CONSULTANTS WHO WORKED WITH THE MEDICAL POLICY STAFF OF THE CARRIER
DURING THE PAST YEAR TO EVALUATE WHETHER EMERGING MEDICAL AND
SURGICAL TREATMENTS SHOULD BE COVERED BY AND PAID FOR BY THE CARRIER;

AND

(VII) THE NAMES OF EACH STATE AND FEDERAL AGENCY AND
EACH FOR-PROFIT OR NONPROFIT ORGANIZATION, TRADE GROUP, OR
TECHNOLOGY COUNCIL THAT CONTRIBUTED TO THE CARRIER'S EVALUATION OF
EMERGING MEDICAL AND SURGICAL TREATMENTS TO DETERMINE WHETHER
THESE TREATMENTS SHOULD BE COVERED AND PAID FOR BY TIDE CARRIER.

(3) THE COMMISSIONER SHALL:

(I) MAKE EACH CARRIER'S REPORT AVAILABLE TO THE PUBLIC
FOR INSPECTION AND REVIEW; AND

(II) PROVIDE A COPY OF A CARRIER'S REPORT TO ANY PERSON
UPON REQUEST IN A TIMELY MANNER AND AT A REASONABLE COST TO THE
PERSON.

(I) A CARRIER MAY NOT CONDITION THE SALARY OR BONUS OF AN
EMPLOYEE OR CONTRACTED PROVIDER ON THE NUMBER OR KIND OF HEALTH
CARE SERVICES THE EMPLOYEE OR CONTRACTED PROVIDER DENIES TO AN
ENROLLEE FOR THE PURPOSE OF SAVING MONEY FOR THE CARRIER OR TO MEET
THE FINANCIAL GOALS OF THE CARRIER

(J) A CARRIER MAY NOT PREVENT A PROVIDER IT EMPLOYS OR A PROVIDER
WITH WHICH THE CARRIER CONTRACTS TO RENDER HEALTH CARE SERVICES TO
ENROLLEES FROM:

(1) PROVIDING ENROLLEES WITH FULL AND OPEN DISCLOSURE OF ALL
THE DIAGNOSTIC OR THERAPEUTIC SERVICES THAT MAY BE APPROPRIATE FOR THE
ENROLLEE'S PARTICULAR DISEASE OR DYSFUNCTION;

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