A. The PCP shall have an effective procedure for reporting to the Department the following information:
- (1) The cost of operations;
- (2) Patterns of utilization;
- (3) The health status of enrollees;
- (4) Information demonstrating that the PCP has a fiscally sound operation; and
- (5) Complaints and grievances made by enrollees.
- B. The PCP shall collect and submit to the Department service specific encounter data by service type in the format and at the frequency designated by the Department.
- C. The PCP shall maintain adequate records to document that the services were delivered.
- D. The PCP shall prepare and submit to the Department quarterly financial and quality assurance reports as specified by the Department.
Authority: Health-General Article, §§2-104(b), 15-103, and 15-105, Annotated Code of Maryland
Effective date
Regulations .01 — .17 adopted as an emergency provision effective June 14, 1995 (22:14 Md. R. 1051); adopted permanently effective October 23, 1995 (22:21 Md. R. 1616)
Regulation .10I amended effective March 30, 2026 (53:6 Md. R. 291)