Md. Code Regs. 31.10.18.08

Current through Register Vol. 51, No. 22, November 1, 2024

Section 31.10.18.08 - Time for Rendering Final Decisions Resulting from Internal Grievance Process

A. Except as otherwise provided in this regulation, a carrier shall render a final decision on a grievance that involves a:

(1) Prospective denial in a nonemergency case within 30 working days after the filing date; and

(2) Retrospective denial within 45 working days after the filing date.

B. With the written consent of the member, member's representative, or health care provider who filed a grievance on behalf of the member, a carrier may extend the period for making a final decision for an additional period of not longer than 30 working days.

Md. Code Regs. 31.10.18.08

Regulations .08 adopted as an emergency provision effective January 1, 1999 (26:2 Md. R. 104); adopted permanently effective March 22, 1999 (26:6 Md. R. 490)