(a) In this Part III of this subtitle the following words have the meanings indicated. (b) “Ambulatory surgical facility” has the meaning stated in § 19–3B–01 of this title. (c) “Carrier” means: (1) An insurer or nonprofit health service plan that holds a certificate of authority and provides health insurance policies or contracts in the State in accordance with […]
(a) In this section, “code” means: (1) The applicable Current Procedural Terminology (CPT) code as adopted by the American Medical Association; or (2) If a CPT code is not available, the applicable code under an appropriate uniform coding scheme approved by the Commission. (b) The Commission shall establish a Maryland medical care data base to compile statewide data on […]
(a) (1) In order to more efficiently establish a medical care data base under § 19–133 of this subtitle, the Commission shall establish standards for the operation of one or more medical care electronic claims clearinghouses in Maryland and may license those clearinghouses meeting those standards. (2) In adopting regulations under this subsection, the Commission shall consider appropriate […]
(a) The Commission may implement a system to encourage health care practitioners to voluntarily control the costs of health care services. (b) The Commission may require health care practitioners of selected health care specialties to cooperate with licensed operators of clinical resource management systems that allow health care practitioners to critically analyze their charges and utilization of […]
In any matter that relates to the utilization or cost of health care services rendered by health care practitioners or office facilities, the Commission may: (1) Hold a public hearing; (2) Conduct an investigation; or (3) Require the filing of any reasonable information.
If the Commission considers a further investigation necessary or desirable to authenticate information in a report that a health care practitioner or office facility files under this subtitle, the Commission may make necessary further examination of the records or accounts of the health care practitioner or office facility, in accordance with the regulations of the […]
