Md. Code Regs. 10.67.12.05

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.67.12.05 - Enrollee Appeal

A. An enrollee shall have 20 days to appeal an MCO's determination of benefit abuse.

B. Except for the time frame specified in §A of this regulation, an appeal shall be handled as specified in COMAR 10.67.71.05.

C. If the appeal results in a hearing, an MCO shall

(1) Attend the hearing; and

(2) Provide justification for enrollment in the program.

Md. Code Regs. 10.67.12.05

Regulations .05 recodified from 10.09.75.05 effective 46:22 Md. R. 976, eff. 11/1/2019