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2000 LAWS OF MARYLAND
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Ch. 371
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BY repealing and reenacting, with amendments,
Article - Insurance
Section 15-10A-02(f), (i), (j), and (k)
Annotated Code of Maryland
(1997 Volume and 1999 Supplement)
BY adding to
Article - Insurance
Section 15-10D-01 through 15 10D 05 15-10D-04, inclusive, to be under the
new subtitle "Subtitle 10D. Complaint Process for Coverage Decisions"
Annotated Code of Maryland
(1997 Volume and 1999 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Insurance
15-10A-02.
(D [Except for an emergency case under subsection (b)(2)(i) of this section, at
the time a member first contacts a carrier about an adverse decision, the carrier shall
send in writing to the member within 2 working days after the initial contact:
(1) the details of its internal grievance process and procedures under the
provisions of this subtitle;
(2) information stating that:
(i) the Health Advocacy Unit:
1. is available to assist the member with filing a grievance
under the carrier's internal grievance process; but
2. is not available to represent or accompany the member
during the proceedings of the internal grievance process;
(ii) the Health Advocacy Unit can assist the member in mediating a
resolution of the adverse decision with the carrier, but that any time during the
mediation, the member or a health care provider on behalf of the member may file a
grievance; and
(iii) the member or a health care provider on behalf of the member
may .file a complaint with the Commissioner without first filing a grievance if
sufficient information and supporting documentation is filed with the complaint that
demonstrates a compelling reason to do so;
(3) the address, telephone number, facsimile number, and e-mail
address of the Health Advocacy Unit;
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- 2102 -
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