Md. Code Ann., Ins. § 15-10C-01
Definitions
Effective Jul 1, 2003Added by Acts 1998, c. 111, § 2, eff. Jan. 1, 1999; Acts 1998, c. 112, § 2, eff. Jan. 1, 1999; Amended by Acts 2003, c. 252, § 10, eff. July 1, 2003; Acts 2017, c. 62, § 6.State of Maryland
- (a) In this subtitle the following words have the meanings indicated.
- (b) “Board” means the State Board of Physicians established under Title 14 of the Health Occupations Article.
- (c) “Certificate” means a certificate issued by the Commissioner under this subtitle to act as a medical director.
- (d) “Department” means the Maryland Department of Health.
- (e) “Health maintenance organization” has the meaning stated in § 19-701 of the Health-General Article.
(f)
(1) “Medical director” means a physician employed by or under contract with a health maintenance organization who is responsible for:
(i) the establishment or maintenance of the policies and procedures at the health maintenance organization for:
- 1. quality assurance; and
- 2. utilization management;
- (ii) compliance with the quality assurance and utilization management policies and procedures of the health maintenance organization; and
- (iii) oversight of utilization review decisions of private review agents employed by or under contract with the health maintenance organization.
- (2) “Medical director” includes an associate medical director or an assistant medical director, as defined by the Commissioner by regulation.
Added by Acts 1998, c. 111, § 2, eff. Jan. 1, 1999; Acts 1998, c. 112, § 2, eff. Jan. 1, 1999; Amended by Acts 2003, c. 252, § 10, eff. July 1, 2003; Acts 2017, c. 62, § 6.