On a quarterly basis, the Health Advocacy Unit shall submit a report to the Commissioner that:
(1) describes activities it performed on behalf of members that have participated in an internal grievance process of a carrier established under this subtitle;
(2) describes its efforts to mediate cases that involve an adverse decision;
(3) names each carrier involved in the cases described in the report;
(4) states the number and outcome of each grievance considered an emergency case under § 15-10A-02(b)(2)(i) of this subtitle described in the report, including the time within which the carrier made a grievance decision on each emergency case; and
(5) states the number and outcome of each case described in the report that was not considered an emergency case, including the time within which the carrier made a grievance decision on the case.
Structure Maryland Statutes
Subtitle 10A - Complaint Process for Adverse Decisions or Grievances
Section 15-10A-01 - Definitions
Section 15-10A-01.1 - Applicability
Section 15-10A-02 - Internal Grievance Process
Section 15-10A-03 - Review of Grievance Decision
Section 15-10A-04 - Decisions -- Final Decision; Notice; Hearing; Remedies for Noncompliance
Section 15-10A-05 - Independent Review Organizations or Medical Experts
Section 15-10A-07 - Quarterly Report to Commissioner by Health Advocacy Unit
Section 15-10A-08 - Annual Summary Report by Health Advocacy Unit
Section 15-10A-09 - Regulations; Right to Challenge Decision Resulting in Nonpayment