Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.21 - Private Review Agents
Section 31.10.21.03 - Specific Criteria and Standards
Universal Citation: MD Code Reg 31.10.21.03
Current through Register Vol. 51, No. 19, September 20, 2024
A. Required Copies. Upon the written request of a person or health care facility, a private review agent shall provide one copy of the specific criteria and standards to be used in conducting utilization review of proposed or delivered services and any subsequent revisions or modifications to the specific criteria and standards.
B. Fee for Copy. A private review agent shall:
(1) Make available a copy of specific criteria and standards used in conducting utilization review of proposed or delivered services for inspection on the premises during normal business hours;
(2) Provide a copy of the specific criteria and standards to a person or health care facility upon request at a reasonable fee determined by the private review agent; and
(3) Provide a copy of the specific criteria and standards upon request to a State agency at no charge to the agency.
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