Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.18 - Denials of Coverage Based on Medical Necessity
Section 31.10.18.08 - Time for Rendering Final Decisions Resulting from Internal Grievance Process
Universal Citation: MD Code Reg 31.10.18.08
Current through Register Vol. 51, No. 19, September 20, 2024
A. Except as otherwise provided in this regulation, a carrier shall render a final decision on a grievance that involves a:
(1) Prospective denial in a nonemergency case within 30 working days after the filing date; and
(2) Retrospective denial within 45 working days after the filing date.
B. With the written consent of the member, member's representative, or health care provider who filed a grievance on behalf of the member, a carrier may extend the period for making a final decision for an additional period of not longer than 30 working days.
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.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
