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PARRIS N. GLENDENING, Governor Ch. 123
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HOURS OR OTHER PRESCRIBED PERIOD OF TIME AFTER THAT ADMISSION IF THE
PATIENTS MEDICAL CONDITION PREVENTED THE HOSPITAL FROM DETERMINING:
(1) THE PATIENT'S INSURANCE STATUS; AND
(2) IF APPLICABLE, THE PRIVATE REVIEW AGENT'S EMERGENCY
ADMISSION NOTIFICATION REQUIREMENTS.
'(D) A PRIVATE REVIEW AGENT MAY NOT RENDER AN ADVERSE DECISION AS
TO AN ADMISSION OF A PATIENT DURING THE FIRST 24 HOURS AFTER ADMISSION
WHEN:
(1) THE ADMISSION IS BASED ON A DETERMINATION THAT THE PATIENT
IS IN IMMINENT DANGER TO SELF OR OTHERS;
(2) THE DETERMINATION HAS BEEN MADE BY THE PATIENT'S
PHYSICIAN OR PSYCHOLOGIST IN CONJUNCTION WITH A MEMBER OF THE MEDICAL
STAFF OF THE FACILITY WHO HAS PRIVILEGES TO MAKE THE ADMISSION; AND
(3) THE HOSPITAL IMMEDIATELY NOTIFIES THE PRIVATE REVIEW
AGENT OF:
(I) THE ADMISSION OF THE PATIENT; AND
(II) THE REASONS FOR THE ADMISSION.
[(g)] (E) (1) A private review agent that requires a health care provider to
submit a treatment plan in order for the private review agent to conduct utilization
review of proposed or delivered services for the treatment of a mental illness,
emotional disorder, or a drug abuse or alcohol abuse disorder:
(i) shall accept the uniform treatment plan form adopted by the
Commissioner under § 15-10B-03(d) of this subtitle as a properly submitted
treatment plan form; and
(ii) may not impose any requirement to:
1. modify the uniform treatment plan form or its content; or
2. submit additional treatment plan forms.
(2) A uniform treatment plan form submitted under the provisions of
this subsection:
(i) shall be properly completed by the health care provider; and
(ii) may be submitted by electronic transfer.
[15-10B-07.
(a) Except as specifically provided in § 15-10B-06 of this subtitle:
(1) except as provided in paragraph (2) of this subsection, all adverse
decisions shall be made by a physician or a panel of other appropriate health care
providers with at least 1 physician on the panel.
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- 755 -
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