§ 15-10C-03

Maryland § 15-10C-03

• Jurisdiction: Maryland
• Article gin: Insurance
• Title: 15

Text

(a) To be certified as a medical director under this subtitle, an applicant shall:

(1) submit an application to the Commissioner on the form required by the Commissioner; and

(2) pay to the Commissioner an application fee of no more than $100 established by the Commissioner by regulation.

(b) The application shall include:

(1) a description of the applicant’s professional qualifications, including medical education information and, if appropriate, board certifications and licensure status;

(2) the utilization management procedures and policies to be used by the health maintenance organization; and

(3) certification by the medical director that the utilization management procedures and policies are:

(i) objective;

(ii) clinically valid;

(iii) compatible with established principles of health care; and

(iv) flexible enough to allow deviations from the norms when justified on a case by case basis.

(c) The delegation by a medical director of any of the medical director’s responsibilities under this subtitle to an associate medical director or an assistant medical director does not prevent the medical director, regardless of the delegation, from being held responsible for any violation of this subtitle.