Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 4
Subtitle 25 - MARYLAND HEALTH CARE COMMISSION
Chapter 10.25.05 - Small Group Market Data Collection
Section 10.25.05.06 - Requests for Data from Nongovernmental Entities
Universal Citation: MD Code Reg 10.25.05.06
Current through Register Vol. 51, No. 19, September 20, 2024
A. Submission of Applications.
(1) An applicant shall complete and submit a
written application in the form and manner specified by the
Commission.
(2) An applicant shall
disclose on an application all potential or approved funding sources at the
time of submission of an application.
(3) If applicable, an applicant shall
disclose any data sharing or other requirements imposed by a funding source as
a condition of receipt of funding.
(4) An applicant shall disclose on an
application whether an applicant or any person or entity that is an officer,
owner, operator, or part of management of an applicant's organization who will
have access and use of the requested data is currently, or has been within 10
years prior to the date of the application, a subject of or a party to a state
or federal regulatory agency action or civil or criminal action involving a
data breach, HIPAA violation, or other matter involving unauthorized access,
use, and disclosure of data regardless of whether there has been a finding or
admission of guilt, including being:
(a)
Convicted of a felony or pleading guilty, nolo contendere, entering a best
interest plea of guilty, or receiving a diversionary disposition regarding a
felony;
(b) A subject of an
investigation conducted by, or a pending complaint, charge, or indictment
issued by, a local, state, or federal governmental regulatory agency or other
state or federal law enforcement agency; or
(c) A party to a final dispositive action in
a state or federal governmental agency regulatory action or a civil action that
resulted in entry into a settlement agreement, consent agreement, decree or
order, corporate integrity agreement, corrective action agreement, or other
similar agreement or other disposition in a civil action regardless of whether
there has been an admission or finding of guilt or liability.
(5) A person who signs an
application shall:
(a) Be an officer of an
applicant's organization who has been given signatory authority to bind the
organization, unless an applicant is not part of an organization and is
requesting data in an applicant's individual capacity, in which case the
applicant shall sign an application; and
(b) Sign the following affirmation statement:
"I solemnly affirm under the penalties of perjury that the contents of the
application and any supplementary information are true to the best of my
knowledge, information, and belief."
(6) An applicant shall pay a nonrefundable
application fee in the amount specified in the list of fees published on the
Commission's website at the time of submission of an application.
B. Completeness Review.
(1) An application is not complete until an
applicant has submitted a completed application, as determined by Commission
staff, and provided any additional information, documentation, answers to
questions, and clarifications requested by Commission staff within the time
limit specified by Commission staff.
(2) After Commission staff has determined
that an application is complete, Commission staff shall refer an application
requesting Medicaid data to Medicaid for review in accordance with Regulation
.04 of this chapter.
(3) If
Commission staff has received a written response from Medicaid specifying its
decision on whether to proceed on the request for Medicaid data under either
Regulation .04B(1), (2) or (3) of this chapter, Commission staff shall refer a
completed application, Medicaid's written response, all supporting
documentation, and any public comment received under Regulation .07 of this
chapter, to the DRAC for further review in accordance with Regulation .09 of
this chapter.
(4) In accordance
with Regulation .04C of this chapter, if Commission staff has not received a
written response from Medicaid within 15 business days of Commission staff's
referral of the application to Medicaid, then Commission staff shall proceed
with processing the application, including the request for Medicaid data, in
accordance with Regulations .07-11 of this chapter.
(5) If Medicaid disapproves the part of an
application requesting Medicaid data pursuant to Regulation .04B(3) of this
chapter, an applicant shall notify Commission staff in writing within 15
business days of an applicant's wishes regarding further consideration of a
non-Medicaid part of an application, specifically, whether an applicant
requests that:
(a) Commission staff refer the
part of a completed application requesting non-Medicaid data to the DRAC for
further review in accordance with Regulation .09 of this chapter; or
(b) An applicant's entire application be
withdrawn and receive no further consideration, in which case Commission staff
shall administratively close the application pursuant to §B(7) of this
regulation.
(6) If an
applicant fails to notify Commission staff in writing within 15 business days
of receiving notice that Medicaid has disapproved the Medicaid part of an
application as required under §B(5) of this regulation, Commission staff
may administratively close an application pursuant to §B(7) of this
regulation.
(7) An application may
be administratively closed and receive no further consideration if:
(a) An applicant fails to provide a complete
application, in the judgment of Commission staff, including providing all
additional information, documentation, answers to questions, and clarifications
requested by Commission staff, or by the DRAC during its review of an
application under Regulation .09 of this chapter, within the time limit
specified by Commission staff or the DRAC; or
(b) An applicant fails to provide the written
notification within 15 business days as required under §B(5) of this
regulation.
(8) For an
applicant to receive further consideration of a request for data in an
application that was administratively closed under §B(7) of this
regulation, an applicant shall file a new application and pay the required fees
that are in effect at the time of submission of a new application.
Disclaimer: These regulations may not be the most recent version. Maryland may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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