Maryland Statutes
Title 15 - Health Insurance
Subtitle 10B - Private Review Agents

Section 15-10B-01 - Definitions - (a) In this subtitle the following words have the meanings...

Section 15-10B-02 - Purpose of Subtitle - The purpose of this subtitle is to: (1) promote the...

Section 15-10B-03 - Certificates -- Required; Issuance; Transferability; Regulations; Uniform Treatment Plan Form - (a) A private review agent may not conduct utilization review...

Section 15-10B-04 - Certificates -- Application; Fees - (a) An applicant for a certificate shall: (1) submit an...

Section 15-10B-05 - Certificates -- Additional Information - (a) In conjunction with the application, the private review agent...

Section 15-10B-06 - Determinations by Private Review Agent - (a) (1) A private review agent shall: (i) make all...

Section 15-10B-07 - Adverse Decisions by Private Review Agent - (a) (1) Except as provided in paragraphs (2) and (3)...

Section 15-10B-08 - Requirements of Internal Grievance Process - (a) If a carrier delegates its internal grievance process to...

Section 15-10B-09 - Requirements of Internal Grievance Process -- Maternity and Newborn Care - (a) In this section, “attending provider” means an obstetrician, pediatrician,...

Section 15-10B-09.1 - Requirements of Grievance Decision - A grievance decision shall be made based on the professional...

Section 15-10B-10 - Certificates -- Expiration; Renewal - (a) A certificate expires on the second anniversary of its...

Section 15-10B-11 - Private Review Agent -- Prohibitions - A private review agent may not: (1) violate any provision...

Section 15-10B-12 - Private Review Agent -- Penalties - (a) (1) A person who violates any provision of §...

Section 15-10B-13 - Right to Hearing and Appeal From Action of Commissioner - Any person aggrieved by an order of the Commissioner under...

Section 15-10B-14 - Waiver of Requirements for Review of Certain Patients - The Commissioner may waive the requirements of this subtitle for...

Section 15-10B-15 - List of Private Review Agents - The Commissioner shall periodically provide a list of private review...

Section 15-10B-16 - Reporting Requirements - The Commissioner may establish reporting requirements to: (1) evaluate the...

Section 15-10B-17 - Patient Referrals by Private Review Agents - (a) (1) Except as provided in paragraph (2) of this...

Section 15-10B-18 - Withdrawal and Submission of Certificate - (a) A private review agent shall advise the Commissioner, in...

Section 15-10B-19 - Examination by Commissioner - (a) Whenever the Commissioner considers it advisable, the Commissioner shall...

Section 15-10B-20 - Examination by Commissioner -- Pharmacy Benefit Manager - (a) In addition to the requirements under § 15-10B-19 of...