PARRIS N. GLENDENING, Governor                             S.B. 624

(a)     There is a Task Force to Study Patient and Provider Appeal and
Grievance Mechanisms;

(b)    The Task Force shall consist of the following members:

(1) Five representatives of the Medical and Chirurgical Faculty of
Maryland, of whom two shall be nonphysician licensed health care providers;

(2) Five representatives of the insurance industry, appointed by the
Maryland Association of Health Maintenance Organizations;

(3) Three members of the House Economic Matters Committee,
appointed by the Speaker of the Maryland House of Delegates; and

(4) Three members of the Senate Finance Committee, appointed by
the President of the Senate of Maryland;

(c) From among the members of the Task Force from the House of
Delegates and the Senate of Maryland, one shall bo designated the House Chairman and
one shall be designated the Senate Chairman;

(1)     Three representatives of the medical and chirurgical faculty of
Maryland, of whom one shall be a nonphysician licensed health care provider, appointed
by the Governor;

(2)     Three representatives of Maryland health maintenance
organizations, appointed by the Governor;

(3)     Three representatives of the House Economic Matters Committee,
appointed by the Speaker of the Maryland House of Delegates;

(4)     Three representatives of the Senate Finance Committee,
appointed by the President of the Senate of Maryland;

(c)     From among the members of the Task Force, the Governor shall
designate a chairman of the Task Force;

(d)    The members of the Task Force shall serve without compensation;

(e)     The Task Force shall:

(1)     Evaluate the use and effectiveness of patient and provider
grievance and appeal mechanisms currently in law that are used to appeal decisions of
health maintenance organizations, including appeal decisions related to enrollee or
subscriber coverage, provider contract termination, and reimbursement determinations;
and

(2)     Based on the evaluation conducted, make recommendations
concerning:

(i) The use and effectiveness of these appeal mechanisms; and

(ii) The need for legislative action; and

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