Ch. 35

1997 LAWS OF MARYLAND

2. SEND WRITTEN NOTICE OF THE ACCEPTANCE OR
REJECTION TO THE PROVIDER AT THE ADDRESS LISTED IN THE APPLICATION.

(IV) THE FAILURE OF A CARRIER TO PROVIDE THE NOTICE
REQUIRED UNDER SUBPARAGRAPH (III)2 OF THIS PARAGRAPH IS A VIOLATION OF
THIS ARTICLE AND THE CARRIER IS SUBJECT TO THE PROVISIONS OF AND
PENALTIES PROVIDED BY §§ 4-113 AND 4-114 OF THIS ARTICLE.

(4) (I) A CARRIER THAT RECEIVES AN INCOMPLETE APPLICATION
SHALL RETURN THE APPLICATION TO THE PROVIDER AT THE ADDRESS LISTED IN
THE APPLICATION WITHIN 10 DAYS AFTER THE DATE THE APPLICATION IS

RECEIVED.

(II) THE CARRIER SHALL INDICATE TO THE PROVIDER WHAT
INFORMATION IS NEEDED TO MAKE THE APPLICATION COMPLETE.

(III) THE PROVIDER MAY RETURN THE COMPLETED APPLICATION
TO THE CARRIER.

(IV) AFTER THE CARRIER RECEIVES THE COMPLETED
APPLICATION, THE CARRIER IS SUBJECT TO THE TIME PERIODS ESTABLISHED IN
PARAGRAPH (3) OF THIS SUBSECTION.

(5) A CARRIER MAY CHARGE A REASONABLE FEE FOR AN APPLICATION
SUBMITTED TO THE CARRIER UNDER THIS SECTION.

(E) PROHIBITED DENIALS AND TERMINATIONS - IN GENERAL.

A CARRIER MAY NOT DENY AN APPLICATION FOR PARTICIPATION OR
TERMINATE PARTICIPATION ON ITS PROVIDER PANEL ON THE BASIS OF:

(1) GENDER, RACE, AGE, RELIGION, NATIONAL ORIGIN, OR A
PROTECTED CATEGORY UNDER THE FEDERAL AMERICANS WITH DISABILITIES ACT;

(2) THE TYPE OR NUMBER OF APPEALS THAT THE PROVIDER FILES
UNDER TITLE 19, SUBTITLE 13 OF THE HEALTH - GENERAL ARTICLE; OR

(3) THE TYPE OR NUMBER OF COMPLAINTS OR GRIEVANCES THAT THE
PROVIDER FILES OR REQUESTS FOR REVIEW UNDER THE CARRIER'S INTERNAL
REVIEW SYSTEM ESTABLISHED UNDER SUBSECTION (H) OF THIS SECTION.

(F) SAME — LICENSING, CERTIFICATION, AND AUTHORIZATION.

(1) A CARRIER MAY NOT DENY AN APPLICATION FOR PARTICIPATION
OR TERMINATE PARTICIPATION ON ITS PROVIDER PANEL SOLELY ON THE BASIS OF
THE LICENSE, CERTIFICATION, OR OTHER AUTHORIZATION OF THE PROVIDER TO
PROVIDE HEALTH CARE SERVICES IF THE CARRIER PROVIDES HEALTH CARE
SERVICES WITHIN THE PROVIDER'S LAWFUL SCOPE OF PRACTICE.

(2) NOTWITHSTANDING PARAGRAPH (1) OF THIS SUBSECTION, A
CARRIER MAY REJECT AN APPLICATION FOR PARTICIPATION OR TERMINATE
PARTICIPATION ON ITS PROVIDER PANEL BASED ON THE PARTICIPATION ON THE
PROVIDER PANEL OF A SUFFICIENT NUMBER OF SIMILARLY QUALIFIED PROVIDERS.

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