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Private Review Agents | Midpage
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Maryland Code
Insurance
Title 15
10b
Private Review Agents
State of Maryland
15-10B-01
Definitions
15-10B-02
Purpose of subtitle
15-10B-03
Certification of private review agent required to conduct utilization review
15-10B-04
Certificate application
15-10B-05
Utilization review plan requirements
15-10B-05.1
Use of artificial intelligence; utilization reviews
15-10B-06
Determinations relating to treatment and health care services
15-10B-07
Adverse decisions and appeals
15-10B-08
Internal grievance process for patients and health care providers
15-10B-09
Review of hospital services related to maternity and newborn care
15-10B-09.1
Grievance decisions
15-10B-10
Renewal and expiration of certificate
15-10B-11
Prohibited actions by private review agents
15-10B-12
Discipline for violation of subtitle
15-10B-13
Right to hearing and appeal
15-10B-14
Waiver of requirements for private review agent
15-10B-15
List of private review agents issued certificates
15-10B-16
Reporting requirements
15-10B-17
Patient referral requirements
15-10B-18
Intention of private review agent to withdraw certificate
15-10B-19
Examination of private review agents
15-10B-20
Examination of pharmacy benefit managers registered as private review agents
15-10B-21
Carriers with patterns of adverse or grievance decisions related to emergency departments