Md. Code, Ins. § 15-10B-05. Utilization review plan requirements: Private Review Agents – Maryland

Status: Enacted
Year Enacted: 1988
Year Amended: 2016
File: Download

Utilization review plans must be submitted to and approved by the commisioner. A utilization review plan shall include the specific criteria and standards to be used in conducting utilization review of proposed or delivered health care services; those circumstances, if any, under which utilization review may be delegated to a hospital utilization review program; and if applicable, any provisions by which patients, physicians, or hospitals may seek reconsideration.

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