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Ch. 123
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2000 LAWS OF MARYLAND
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(b) (1) In addition to the provisions of subsection (a) of this section, the
Commissioner may impose an administrative penalty of up to $5,000 for a violation of
any provision of this subtitle.
(2) The Commissioner shall adopt regulations to provide standards for
the imposition of an administrative penalty under paragraph (1) of this subsection.]
15-10B-17.
(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 DELIVERED BY A PROVIDER
WHO IS A PARTICIPATING OR NONPARTICIPATING PROVIDER IN THE PREFERRED
PROVIDER ORGANIZATION OR EMPLOYEE ASSISTANCE PROGRAM NETWORK.
(B) A PRIVATE REVIEW AGENT OR ANY INDIVIDUAL WHO IS EITHER
AFFILIATED WITH, UNDER CONTRACT WITH, OR ACTING ON BEHALF OF A PRIVATE
REVIEW AGENT MAY NOT:
(1) REFER A PATIENT WHO HAS UNDERGONE UTILIZATION REVIEW BY
THE PRIVATE REVIEW AGENT TO:
(I) A HEALTH CARE FACILITY IN WHICH THE PRIVATE REVIEW
AGENT OWNS A SIGNIFICANT BENEFICIAL INTEREST; OR
(II) THE PRIVATE REVIEW AGENT'S OWN HEALTH CARE PRACTICE;
(2) PAY OR AGREE TO PAY ANY SUM TO, OR ACCEPT OR AGREE TO
ACCEPT ANY SUM FROM, ANY PERSON FOR BRINGING OR REFERRING A PATIENT TO
THE PRIVATE REVIEW AGENT; OR
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- 766 -
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