Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 4. |
Subtitle 25. MARYLAND HEALTH CARE COMMISSION |
Chapter 10.25.01. Small Employer Health Benefits Plan Premium Subsidy Program |
Sec. 10.25.01.23. Appeals of Decisions of the Executive Director
-
A. Decisions of the Executive Director may be appealed to the Commission.
B. The appeal shall be in writing and filed with the Commission within 30 days of the date of the decision of the Executive Director.
C. The appeal shall state specifically the facts of the situation and the justification for the Commission to change the decision of the Executive Director. The appeal may:
(1) Present significant, relevant information that was not previously presented to the Commission and that, with reasonable diligence, could not have been presented before the Executive Director made a decision;
(2) Demonstrate that there have been significant changes in factors or circumstances relied upon by the Executive Director in reaching the decision; or
(3) Demonstrate that the Executive Director has materially failed to follow the Commission's adopted procedures in reaching the decision.
D. Within 15 days of the filing of the appeal, the Executive Director shall submit a written response to the appeal and send it to the appellant. The appellant shall have 10 days to submit a written response for consideration by the Commission.
E. The Commission may act on the appeal in one of the following ways:
(1) By a majority vote of the full Commission;
(2) By a majority vote of an appeals committee, whose members shall be appointed by the Chair of the Commission; or
(3) By a decision of an appeals commissioner, appointed by the Chair of the Commission.
F. The Chair of the Commission shall determine which of the methods under §E of this regulation the Commission will use to act on the appeal.
G. The Commission may act on the appeal based on the written appeal record alone, or may hold a hearing before acting on the appeal.
H. The Commission may affirm, reverse, or modify the decision of the Executive Director and shall make written findings of fact and conclusions of law stating the basis for its decision within 30 days of its decision on the appeal.