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 31.10.18.12 - General Procedures for Complaints
Universal Citation: MD Code Reg 31.10.18.12
Current through Register Vol. 51, No. 19, September 20, 2024
A. Consent Form.
(1) For services rendered on or after January 1, 1999, the Commissioner shall request the signed consent of the member that filed the complaint, or a legally authorized designee of the member, authorizing the release of the member's medical records to the Commissioner or the Commissioner's designee that are needed in order for the Commissioner to make a final decision on the complaint.
(2) The Commissioner may refuse to investigate a complaint if the member or legally authorized designee of the member fails to sign a consent form.
(3) In the case of alcohol and drug abuse, the member shall deliver the member's medical records to the Health Advocacy Unit or to the Commissioner, or to both, pursuant to federal law and regulations.
B. The Commissioner may refer complaints not within the Commissioner's jurisdiction to the Health Advocacy Unit or any other appropriate federal or state government agency or unit for disposition or resolution.
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