Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.21 - Private Review Agents
Section 31.10.21.11 - Accredited Private Review Agents and Filing Requirement Waivers

Universal Citation: MD Code Reg 31.10.21.11

Current through Register Vol. 51, No. 19, September 20, 2024

A. Determination of Approved Accrediting Organization.

(1) An accrediting organization is not an approved accrediting organization until the Commissioner issues a letter of approval to the accrediting organization.

(2) For the purpose of determining which entities are approved accrediting organizations, the Commissioner shall consider whether:
(a) Some or all of the accreditation standards required to be met for accreditation by the accrediting organization meet or exceed the requirements of Insurance Article, Title 15, Subtitles 10A and 10B, Annotated Code of Maryland;

(b) The accrediting organization measures an applicant's ability to meet each standard; and

(c) The accrediting organization agrees to notify the Commissioner at least 30 days in advance if it revises its accreditation standards or changes the method in which it reviews private review agents.

(3) The approved accrediting organization continues to be approved by the Commissioner until notified in writing by the Commissioner that its approval has been withdrawn.

B. Demonstration by Applicant of Meeting Filing Requirement through Accreditation.

(1) An applicant for a private review agent certification may request an exemption from a particular filing requirement of this chapter if the applicant:
(a) Is accredited by an approved accrediting organization; and

(b) Submits the following information to the Commissioner for approval:
(i) A list of the filing items for which the private review agent applicant is requesting exemption;

(ii) The letter of accreditation from an approved accrediting organization;

(iii) The standards by which the private review agent applicant was measured by the approved accrediting organization; and

(iv) Evidence that the private review agent applicant met or exceeded each accreditation standard for which the private review agent applicant is requesting a filing exemption.

(2) In addition to the information specified in §B(1) of this regulation, the Commissioner may request additional information before granting the filing exemption provided by this regulation.

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