Source: https://law.justia.com/codes/maryland/2013/article-gin/section-15-10c-04/
Timestamp: 2020-07-10 12:24:32
Document Index: 130027804

Matched Legal Cases: ['§ 15', '§ 15', '§ 15', '§ 15', '§ 2', '§ 15']

§ 15-10C-04 - Suspension or revocation by Commissioner of certificate of Medical Director :: 2013 Maryland Code :: US Codes and Statutes :: US Law :: Justia
Justia US Law US Codes and Statutes Maryland Code 2013 Maryland Code INSURANCE § 15-10C-04 - Suspension or revocation by Commissioner of certificate of Medical Director
§ 15-10C-04 - Suspension or revocation by Commissioner of certificate of Medical Director
MD Ins Code § 15-10C-04 (2013) What's This?
(a) Refusing to renew a certificate. -- Subject to the hearing procedures in §§ 2-210 through 2-214 of this article, the Commissioner may suspend, revoke, or refuse to renew a certificate of a medical director if the Commissioner finds a pattern that the utilization management procedures and policies used by the medical director in making utilization review decisions or used by a private review agent employed by or under contract with the health maintenance organization over whose utilization review decisions the medical director has responsibility are not:
(3) compatible with established principles of health care; or
(4) flexible enough to allow deviations from the norms when justified on a case by case basis.
(b) Independent experts. -- The Commissioner may consult with an independent review organization or medical expert that meets the requirements of § 15-10A-05 of this title, the Department, the Board, or any other appropriate entity for purposes of taking an action described under subsection (a) of this section.