Md. Code Regs. 31.10.22.04

Current through Register Vol. 51, No. 18, September 6, 2024

Section 31.10.22.04 - Application for Certificate of Authority

A. Submission of Application. An applicant shall submit an application for a certificate of authority to the Commissioner at least 90 days before the date that the applicant proposes to engage in business in the State.

B. Provision of Application Form. The Commissioner shall provide an application form to an applicant on request.

C. Filing of Information. Each applicant seeking a certificate of authority to transact business in the State shall file the following items with the Commissioner:

(1) If incorporated, a copy of the articles of incorporation of the applicant and any amendments to the articles of incorporation, certified by the Department of Assessments and Taxation;

(2) A copy of the applicant's current bylaws, certified by the appropriate officer of the applicant;

(3) A list of the names, addresses, and official capacity with the applicant of the individuals who are to be responsible for conducting the applicant's affairs, including all members of the governing body, the officers and directors in the case of a corporation, and the partners or associates in the case of a partnership or association;

(4) A resume of the qualifications of the administrator, the medical director, each officer, and each other individual associated with the applicant or as requested by the Commissioner;

(5) A statement generally describing the:

(a) Applicant and its structure,

(b) Applicant's operations,

(c) The location of the facilities at which health care services will be regularly available to members, and

(d) The type, specialty, and number of physicians and health care personnel engaged or contracted with to provide health care services;

(6) A statement describing with reasonable certainty the geographic area to be served by the applicant;

(7) A certified statement of the financial condition of the applicant, including:

(a) Sources of financial support,

(b) Assets and liabilities and minimum net worth, and

(c) Other financial information the Commissioner requires for adequate financial evaluation;

(8) Copies of proposed techniques and methods of marketing the services of the applicant;

(9) A power of attorney duly executed by the applicant appointing the Commissioner and the Commissioner's duly authorized deputies as the true and lawful attorney of the applicant in and for the State on whom may be served all lawful process in any action, proceeding, or cause of action arising in the State against the applicant;

(10) A certificate of compliance evidencing employee coverage under the Maryland Workers' Compensation Act (Labor and Employment Article, Title 9, Annotated Code of Maryland); and

(11) A prospective budget and expected cash flow analysis for the first 12 months of the applicant's anticipated operation, demonstrating its financial viability based on reasonable assumptions.

D. Disclosure. Each individual who is responsible for the conduct of the affairs of an applicant shall disclose to the Commissioner and the governing body of the applicant the extent and nature of any contracts or arrangements between the individual and the applicant, including any possible conflicts of interest.

E. Insurance-General Liability and Medical Malpractice.

(1) An applicant may not obtain a certificate of authority until the applicant:

(a) Submits to the Commissioner evidence of general liability and medical malpractice insurance or a plan of self-insurance to cover general liability and medical malpractice; and

(b) Obtains approval of its insurance or plan of self-insurance from the Commissioner with respect to the amount of coverage and type of coverage.

(2) With each annual report, a provider-sponsored organization shall submit to the Commissioner evidence of renewal of insurance or continuation of self-insurance.

F. Advertising. Before using any advertising that has been approved by the Health Care Financing Administration, a provider-sponsored organization shall file a copy of the advertising with the Commissioner.

Md. Code Regs. 31.10.22.04

Regulations .04 adopted as an emergency provision effective June 29, 1999 (26:15 Md. R. 1146); emergency status extended at 27:3 Md. R. 326; emergency status expired April 17, 2000; adopted permanently effective May 15, 2000 (27:9 Md. R. 860)