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10.25.07.00.htm 10.25.07.00. Title 10 MARYLAND DEPARTMENT OF HEALTH Subtitle 25 MARYLAND HEALTH CARE COMMISSION Chapter 07 Certification of Electronic Health Networks and Medical Care Electronic Claims Clearinghouses Authority: Health-General Article, §4-302.1, 19-103(c)2) (9) and (10) 19-109(a)1) 19-134, and 19-135(a) and (b) Annotated Code of Maryland
10.25.07.01.htm 10.25.07.01. 01 Scope.. This chapter provides for the certification of electronic health networks and medical care electronic claims clearinghouses that operate in Maryland. Payors that accept electronic health care transactions originating in Maryland may only accept electronic health care transactions from electronic health networks or medical care electronic claims clearinghouses that obtain certification pursuant to this chapter.
10.25.07.02.htm 10.25.07.02. 02 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Commission" means the Maryland Health Care Commission.. 2) "Electronic health care transactions" means health care transactions that have been approved by a nationally recognized health care standards development organization (SDO) to support health care informatics, information exchange, systems integration, and other health care applications.3) "Electronic Health Net
10.25.07.03.htm 10.25.07.03. 03 Duration of Certification.. A certification is valid for a 2-year period from the date of certification unless withdrawn by the Commission prior to the end of the 2-year period.
10.25.07.04.htm 10.25.07.04. 04 Procedure to Obtain Certification.. A. Application for Certification. An EHN seeking Commission certification shall:. 1) Complete and submit an application for MHCC Electronic Health Network Certification in the form and manner specified by the Commission;2) Provide evidence that it has been granted either candidacy status or full accreditation or certification status by a qualified accreditation or certification organization; and
10.25.07.05.htm 10.25.07.05. 05 Standards for Certification.. A. In order to obtain certification, an applicant shall:. 1) Provide evidence that the applicant is accredited or certified by a qualified accreditation or certification organization; and2) Meet the following standards for certification:. a) Demonstrate compliance with the HIPAA privacy standards set forth in 45 C.F.R. §160 and 164;. b) Demonstrate compliance with HIPAA security standards set forth in 45 C.F.R. §160, 162, and 164;.
10.25.07.06.htm 10.25.07.06. 06 Candidacy Status.. A. Subject to the provisions of this section, the Commission shall issue candidacy status to an applicant that:1) Has been granted candidacy status by a qualified accreditation or certification organization;. 2) Has submitted an application for certification to the Commission;. 3) Has paid the application fee; and. 4) Has submitted documentation satisfactory to the Commission demonstrating compliance with the requirements set forth in Reg
10.25.07.07.htm 10.25.07.07. 07 Notice Required.. A. Within 30 days after the closure, sale, lease, assignment, or transfer of an MHCC-certified EHN to any person or entity, the MHCC-certified EHN and the other party to the transaction shall notify the Commission of that event. Upon such notice, the Commission may seek further information to determine whether the certification should remain in effect notwithstanding the sale or other event.B. At least 60 days before changing its address, a
10.25.07.08.htm 10.25.07.08. 08 Renewal of Certification.. A. Application for renewal of certification shall be made at least 60 days before the expiration of the certification in a form and manner specified by the Commission.B. A recertification fee shall be paid to the Commission at the time the MHCC Electronic Health Network recertification application is filed.C. For an electronic health network with one operational site, a recertification fee of $250 shall be paid at the time the application is filed.
10.25.07.09.htm 10.25.07.09. 09 Withdrawal of Certification.. The Commission may withdraw certification from an MHCC-certified EHN if the Commission finds that:. A. The MHCC-certified EHN fails to meet the certification standards set forth in Regulation .05 of this chapter;B. A principal or owner of the MHCC-certified EHN, or the entity itself, is convicted of, or pleads guilty or nolo contendere to, a crime related to the operation of the EHN or to a crime involving financial improprieties; or
10.25.07.10.htm 10.25.07.10. 10 Notice Prior to Withdrawal.. A. Before withdrawal of certification on one of the bases provided in Regulation .09 of this chapter, the Executive Director shall inform the MHCC-certified EHN, setting forth in writing the reasons for withdrawal.B. The notice of withdrawal shall set forth the right of the MHCC-certified EHN to an evidentiary hearing, conducted in accordance with Regulation .11 of this chapter, to show cause why the certification should not be withdrawn.
10.25.07.11.htm 10.25.07.11. 11 Hearing Procedures.. A. Reviewer as Presiding Officer.. 1) If an evidentiary hearing is requested, the Executive Director shall appoint a single commissioner to act as reviewer and preside at the hearing.2) The reviewer shall hold a prehearing conference, at which the reviewer shall:. a) Summarize the rules of procedure governing the evidentiary hearing;. b) Determine the date, time, and place of the evidentiary hearing;.
10.25.07.9999.htm 10.25.07.9999. Administrative History Effective date: July 15, 1996 (23:14 Md. R. 1008). Regulation .01 amended effective July 23, 2001 (28:14 Md. R. 1322). Regulation .02 amended effective April 3, 2000 (27:6 Md. R. 641). Regulation .03 amended effective July 23, 2001 (28:14 Md. R. 1322). Regulation .05 amended effective April 15, 2002 (29:7 Md. R. 620). Regulation .10 amended effective July 23, 2001 (28:14 Md. R. 1322). Regulation .11 amended effective April 3, 2000 (27
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