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.
Structure Maryland Statutes
Subtitle 10B - Private Review Agents
Section 15-10B-01 - Definitions
Section 15-10B-02 - Purpose of Subtitle
Section 15-10B-04 - Certificates -- Application; Fees
Section 15-10B-05 - Certificates -- Additional Information
Section 15-10B-06 - Determinations by Private Review Agent
Section 15-10B-07 - Adverse Decisions by Private Review Agent
Section 15-10B-08 - Requirements of Internal Grievance Process
Section 15-10B-09 - Requirements of Internal Grievance Process -- Maternity and Newborn Care
Section 15-10B-09.1 - Requirements of Grievance Decision
Section 15-10B-10 - Certificates -- Expiration; Renewal
Section 15-10B-11 - Private Review Agent -- Prohibitions
Section 15-10B-12 - Private Review Agent -- Penalties
Section 15-10B-13 - Right to Hearing and Appeal From Action of Commissioner
Section 15-10B-14 - Waiver of Requirements for Review of Certain Patients
Section 15-10B-15 - List of Private Review Agents
Section 15-10B-16 - Reporting Requirements
Section 15-10B-17 - Patient Referrals by Private Review Agents
Section 15-10B-18 - Withdrawal and Submission of Certificate
Section 15-10B-19 - Examination by Commissioner
Section 15-10B-20 - Examination by Commissioner -- Pharmacy Benefit Manager