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Session Laws, 2000
Volume 797, Page 764   View pdf image
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2000 LAWS OF MARYLAND
Ch. 123
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.] 15-10B-14. 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-15. A private review agent may not disclose or publish individual medical records or
any other confidential medical information obtained in the performance of utilization
review activities.] 15-10B-15. 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-16. (a) (1) Except as provided in paragraph (2) of this subsection, this section
does not apply to: (i) a private review agent referring an individual to a health care
provider or facility that participates in a health maintenance organization; (ii) a preferred provider organization network of participating
health care providers or facilities to which the individual would otherwise be referred
as part of the individual's membership or insurance contract; or (iii) an employee assistance program referring an individual to a
network of participating health care providers or facilities in accordance with a
contract with the individual's employer or labor union to provide comprehensive
mental health and substance abuse services. (2) A private review agent or any other individual who is either affiliated
with, under contract with, or acting on behalf of a private review agent may not
approve or fail to approve a course of treatment based on whether the treatment is
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Session Laws, 2000
Volume 797, Page 764   View pdf image
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