Ch. 394

2003 LAWS OF MARYLAND

purposes for which the Account may be used; requiring nursing homes that
receive payment from the Medical Assistance Program to provide certain
financial information to the Department of Health and Mental Hygiene on a
quarterly basis; requiring the Department to conduct third party liability
reviews of certain financial information of nursing homes that receive payment
from the Medical Assistance Program; requiring authorizing the Department to
conduct third party liability audits of a random sample of nursing homes that
receive payment from the Medical Assistance Program; authorizing the
Department to conduct third party liability audits of certain nursing homes
under certain conditions; requiring that the audits be conducted at a certain
frequency; authorizing the Department to contract with an entity to perform the
audits; requiring the Department to use certain procurement procedures when
making certain contracts; requiring audit contracts to include certain items;
prohibiting audit contractors from being compensated in a certain manner;
requiring audit contractors to complete certain reports on a certain frequency;
requiring certain reports to include certain items; authorizing the Secretary to
establish certain appeals boards; designating the membership of the appeals
boards; authorizing a nursing home to appeal the final report of a third party
liability audit within a certain time period; requiring a certain individual within
the Department to conduct a certain review of a certain appeal by a nursing
home and issue a certain report; authorizing a nursing home to appeal the
results of a certain report to the Nursing Home Appeal Board within a certain
time period; requiring State general funds recovered through third party
liability audits to be deposited into the Account; authorizing the Department to
adopt regulations regarding third party liability reviews and audits; requiring
the Department of Health and Mental Hygiene and the Department of Human
Resources to conduct a study of the Medical Assistance Program eligibility
process for nursing home residents; requiring the Department of Health and
Mental Hygiene and the Department of Human Resources to submit a report to
the Governor and certain committees of the General Assembly on or before a
certain date; and generally relating to third party liability reviews and audits of
nursing homes.

BY repealing and reenacting, with amendments,
Article—Health—General
Section 19-1407(a) and (b)
Annotated Code of Maryland
(2000 Replacement Volume and 2002 Supplement)

BY adding to                                                                                     

Article - Health - General
Section 19-14A-01 through 19-14A-06 19-14A-04, inclusive, to be under the

new subtitle "Subtitle 14A. Third Party Liability Reviews and Audits of

Nursing Homes"
Annotated Code of Maryland
(2000 Replacement Volume and 2002 Supplement)

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