Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 14. Independent Agencies |
Subtitle 35. MARYLAND HEALTH BENEFIT EXCHANGE |
Chapter 14.35.11. Fair Hearings of Individual Exchange Eligibility Determinations |
Sec. 14.35.11.07. Hearing Procedures
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A. The appellant and the Exchange shall have the opportunity to:
(1) Present witnesses;
(2) Present documentary evidence;
(3) Present oral and written argument without undue interference;
(4) Establish all facts and circumstances the administrative law judge judges to be relevant; and
(5) Question or refute any testimony or evidence, including an opportunity to confront and cross-examine all witnesses the administrative law judge judges to be adverse.
B. All parties that wish to call a witness at the hearing shall subpoena the witness in accordance with Office of Administrative Hearings procedures in COMAR 28.02.01.14. The appellant or authorized representative may subpoena any employee of the Exchange whose action is being contested by the appellant or whose testimony may be relevant to the issues under consideration as determined by the administrative law judge.
C. Right to Review Record.
(1) If the Exchange introduces as evidence documents from the case record, special investigation file, or other sources, the appellant shall have the opportunity to examine the:
(a) Persons who prepared the documents; and
(b) Case record or special investigation file for the purpose of discovering information favorable to the appellants case.
(2) The Exchange shall have access to relevant portions of the appellants medical record in accordance with Health-General Article, 4-305, Annotated Code of Maryland, to the extent required by law.
D. To the extent required by law, when a hearing involves a medical issue, such as a diagnosis, an examining physicians report, or a medical review teams decision, an additional medical assessment of the appellants condition shall be obtained and made part of the record if the administrative law judge considers it necessary. Any additional medical assessment shall be made by a person other than the person who made the original medical assessment and shall be obtained at the Exchanges expense.