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31.10.20.00.htm 31.10.20.00. Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 10 HEALTH INSURANCE ― GENERAL Chapter 20 Certification of HMO Medical Directors Authority: Insurance Article, §2-109 and 15-10C-02, Annotated Code of Maryland
31.10.20.01.htm 31.10.20.01. 01 Definitions.. A. In this chapter, the following terms have the meanings indicated.. B. Terms Defined.. 1) "Administration" means the Maryland Insurance Administration.. 2) "Board" means the State Board of Physician Quality Assurance established under Health Occupations Article, Title 14, Annotated Code of Maryland.3) "Certificate" means a certificate, issued by the Commissioner under this chapter, to act as a med4) "Commissioner" means the State Insurance Commissioner..
31.10.20.02.htm 31.10.20.02. 02 Issuance of a Temporary Certificate.. A. Not later than the date of hire, a medical director seeking temporary certification shall submit to the Commissioner an application for certification on a form specified by the Commissioner.B. The medical director shall attach the following additional information to the application:. 1) A description of the applicant's professional qualifications, including medical education, medical training and experience, clinical experience, hi
31.10.20.03.htm 31.10.20.03. 03 Certification.. A. A medical director shall hold a certificate from the Commissioner that authorizes the applicant to act as the medical director of a health maintenance organization.B. To qualify for a certificate to act as a medical director of a health maintenance organization, the applicant:1) Shall be a physician licensed to practice medicine in Maryland;. 2) Shall have one of the following:. a) An advanced health-related degree;. b) Current board certific
31.10.20.04.htm 31.10.20.04. 04 Denial or Revocation of Certification.. A. The Commissioner shall deny a certificate to an applicant if the Commissioner finds that the initial application does not meet the requirements of this chapter.B. The Commissioner may revoke the certification of a medical director:. 1) Who violates any provision of this chapter;. 2) Who fails to meet the requirements for certification under Regulation .04B of this chapter;. 3) Who obtains certification based on inaccurate information;.
31.10.20.05.htm 31.10.20.05. 05 Term of Certification and Recertification.. A. A certificate:. 1) Is not transferable; and. 2) Expires on the second anniversary of its effective date unless certification has been renewed for another 2-year term.B. Before certification expires, a medical director may renew certification if the certified medical director:1) Otherwise is entitled to be certified;. 2) Pays to the Commissioner the nonrefundable renewal fee of $100; and. 3) Submits to the Commissioner:.
31.10.20.06.htm 31.10.20.06. 06 Notification to the Board of Physician Quality Assurance.. A. The Commissioner shall annually provide to the Board a list of certified individuals authorized by the Commissioner to act as a medical director.B. The Commissioner shall notify the Board of the revocation of a certificate issued under this chapter.
31.10.20.9999.htm 31.10.20.9999. Administrative History Effective date:. Regulations .01―07 adopted as an emergency provision effective January 1, 1999 (26:1 Md. R. 18) adopted permanently effective March 22, 1999 (26:6 Md. R. 490) ―Chapter revised effective May 9, 2016 (43:9 Md. R. 532). Regulation .01B amended effective August 27, 2018 (45:17 Md. R. 804). Regulation .03 amended effective August 27, 2018 (45:17 Md. R. 804).
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