|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
S.B. 190
|
|
|
|
|
|
VETOES
|
|
|
|
|
|
|
|
|
|
|
|
|
|
[15-10B-12.
The Commissioner may waive the requirements of this subtitle for a private
review agent that operates solely under contract with the federal government for
utilization review of patients eligible for hospital services under Title XVIII of the
Social Security Act.]
15-10B-12.
(A) (1) A PERSON WHO VIOLATES ANY PROVISION OF § 15-10B-11 OF THIS
SUBTITLE IS GUILTY OF A MISDEMEANOR AND ON CONVICTION IS SUBJECT TO A
PENALTY NOT EXCEEDING $1,000.
(2) EACH DAY A VIOLATION IS CONTINUED AFTER THE FIRST
CONVICTION IS A SEPARATE OFFENSE.
(B) IN ADDITION TO THE PROVISIONS OF SUBSECTION (A) OF THIS SECTION, IF
ANY PERSON VIOLATES ANY PROVISION OF § 15-10B-11 OF THIS SUBTITLE, THE
COMMISSIONER MAY;
(1) DENY, SUSPEND, OR REVOKE THE CERTIFICATE TO DO BUSINESS AS
A PRIVATE REVIEW AGENT;
(2) ISSUE AN ORDER TO CEASE AND DESIST FROM ACTING AS A PRIVATE
REVIEW AGENT WITHOUT HOLDING A CERTIFICATE ISSUED UNDER THIS SUBTITLE;
(2) (3) REQUIRE A PRIVATE REVIEW AGENT TO MAKE RESTITUTION TO
A PATIENT WHO HAS SUFFERED ACTUAL ECONOMIC DAMAGE BECAUSE OF THE
VIOLATION; AND
(3) (4) IMPOSE AN ADMINISTRATIVE PENALTY OF UP TO $5,000 FOR
EACH VIOLATION OF ANY PROVISION OF THIS SUBTITLE.
[15-10B-13.
The Commissioner shall periodically provide a list of private review agents
issued certificates and the renewal date for those certificates to any person on
request.]
15-10B-13.
ANY PERSON AGGRIEVED BY AN ORDER OF THE COMMISSIONER UNDER THIS
SUBTITLE HAS THE RIGHT TO A HEARING AND THE RIGHT TO APPEAL FROM THE
ACTION OF THE COMMISSIONER IN ACCORDANCE WITH §§ 2-210 THROUGH 2-215 OF
THIS ARTICLE.
[15-10B-14.
The Commissioner may establish reporting requirements to:
(1) evaluate the effectiveness of private review agents; and
(2) determine if the utilization review programs are in compliance with
the provisions of this section and applicable regulations.]
|
|
|
|
|
|
|
|
|
|
- 3768 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
