Sec. 30.08.13.06. Procedures for Disciplinary Actions

A. MIEMSS shall initiate an action to place a trauma or specialty referral center on probation or to lower, suspend, or revoke a trauma or specialty referral center's designation if MIEMSS:

(1) Determines that the violation warrants probation, lowered level of designation, suspension, or revocation; or

(2) Has required a plan of corrective action, and:

(a) The trauma or specialty referral center fails to submit a plan within the time set by MIEMSS, or

(b) MIEMMS determines that the trauma or specialty referral center has not satisfactorily complied with the plan.

B. Notice of Action.

(1) MIEMSS shall notify a trauma or specialty referral center of the disciplinary action by issuing a written notice of suspension, revocation, lowered level of designation, or probation to the chief executive officer of the hospital.

(2) The notice of suspension, revocation, lowered level of designation, or probation shall conform to State Government Article, §10-207, Annotated Code of Maryland.

(3) MIEMSS shall notify the EMS Board of the action taken.

C. Except in the case of an emergency suspension or revocation under §F of this regulation, the suspension, revocation, lowered level of designation, or probation is stayed pending the final agency decision.

D. Informal Meeting.

(1) Not later than 15 business days from the date a trauma or specialty referral center receives a notice of suspension, revocation, lowered level of designation, or probation, the trauma or specialty referral center may request, in writing, an informal meeting with MIEMSS to discuss MIEMSS' action.

(2) The meeting shall be held not later than 10 business days from the date MIEMSS receives the request.

(3) If the trauma or specialty referral center does not timely request an informal meeting, MIEMSS' notice of suspension, revocation, lowered level of designation, or probation is the final agency decision.

E. Request for Hearing.

(1) This section does not apply to an emergency revocation or suspension hearing under §F of this regulation.

(2) If the trauma or specialty referral center is not satisfied with the result of the informal meeting, not later than 15 business days from the date of the meeting, it may request a hearing by sending a written request for a hearing by certified mail, return receipt requested, addressed to the MIEMSS Office of Hospital Programs in Baltimore, Maryland.

(3) Not later than 5 business days from the date of receipt of a timely request for a hearing, MIEMSS shall forward the request to OAH.

(4) From the date OAH receives the hearing request, OAH shall schedule a hearing as soon as practicable for all parties and OAH, but not later than:

(a) 60 calendar days for temporary suspensions or revocations; or

(b) 90 calendar days for all other hearings.

(5) The hearing is conducted in accordance with the procedures set forth in §G of this regulation.

(6) If the trauma or specialty referral center does not request a hearing in a timely manner, MIEMSS' notice of suspension, revocation, lowered level of designation, or probation is the final agency decision.

F. Emergency Revocation or Suspension.

(1) If MIEMSS determines that grounds exist that require immediate suspension or revocation of designation for the public's protection, MIEMSS may issue a notice of immediate suspension or revocation of designation to the chief executive officer of the trauma or specialty referral center.

(2) The suspension or revocation of designation is effective immediately upon service of the notice of immediate suspension or revocation of designation.

(3) Request for Hearing.

(a) Not later than 15 business days after service of the notice of immediate suspension or revocation of designation, the trauma or specialty referral center may request a hearing by sending a written request for a hearing by certified mail, return receipt requested, addressed to the MIEMSS Office of Hospital Programs in Baltimore, Maryland.

(b) Requesting a hearing does not negate, or act as a stay of, the suspension or revocation.

(c) If the trauma or specialty referral center does not request a hearing in a timely manner, MIEMSS' notice of immediate suspension or revocation of designation is the final agency decision.

(4) Upon receipt of a hearing request, MIEMSS shall send a written request to OAH to schedule a hearing.

(5) OAH shall conduct the hearing within 10 business days of the date it receives the hearing request, except that the time period may be extended by:

(a) OAH for good cause; or

(b) Agreement of the trauma or specialty referral center and MIEMSS.

(6) Except as modified in this section, the hearing shall be conducted in accordance with the procedures set forth in §G of this regulation.

(7) Not later than 10 business days after the close of the hearing record, OAH shall issue a proposed decision that includes proposed findings of fact and conclusions of law and a proposed order, except that the time period may be extended by:

(a) OAH for good cause; or

(b) Agreement of the trauma or specialty referral center and MIEMSS.

(8) Appeal to the EMS Board.

(a) Filing of Exceptions.

(i) Not later than 5 business days from the date it receives the proposed decision, a party aggrieved by the proposed decision may appeal by filing written exceptions with the Executive Director, for consideration by the EMS Board.

(ii) The exceptions shall state with specificity the reasons why the proposed decision should be overturned.

(iii) A party filing exceptions may request an oral argument and shall submit the request with the exceptions.

(iv) A party filing exceptions shall mail a copy of its exceptions to the opposing party by first class mail, postage prepaid.

(v) If exceptions are not filed within the specified time period, the OAH proposed decision is the final agency decision.

(b) Response to Exceptions.

(i) Not later than 5 business days after the opposing party receives a copy of the exceptions, the opposing party may file a response with the EMS Board.

(ii) A party filing a response may request an oral argument and shall submit the request with the response.

(iii) A party filing a response shall mail a copy of its response to the party filing exceptions by first class mail, postage prepaid.

(c) Decision of EMS Board.

(i) Not later than 30 calendar days after the filing of the exceptions or the response, whichever is later, the EMS Board shall issue a written decision granting or denying the exceptions.

(ii) The EMS Board may, in its discretion, rule on the exceptions with or without oral argument.

(d) If the EMS Board denies the exceptions, the proposed decision, as affirmed by the EMS Board, is the final agency decision.

(e) If the EMS Board grants the exceptions, in whole or in part, the EMS Board shall modify the proposed decision accordingly and the modified decision is the final agency decision.

(f) The EMS Board shall issue its final decision in accordance with State Government Article, §§10-220 and 10- 221, Annotated Code of Maryland.

(9) A party aggrieved by a final agency decision may seek judicial review in accordance with State Government Article, §10-222, Annotated Code of Maryland, and the Maryland Rules of Civil Procedure.

G. Hearing Procedures.

(1) A hearing shall be conducted in accordance with the procedures and regulations of OAH set forth in COMAR 28.02.01, except as modified by this regulation.

(2) Confidential Materials Not Discoverable.

(a) In addition to the restrictions on discovery of documents under COMAR 28.02.01.10, a party is not entitled to discovery of any confidential:

(i) Record;

(ii) File;

(iii) Memorandum;

(iv) Correspondence;

(v) Document;

(vi) Object; or

(vii) Other tangible thing.

(b) For purposes of this regulation, all records, files, memoranda, correspondence, documents, objects, other tangible things, notes, minutes of conferences, and any other communications of members of an on-site review team are confidential.

(c) This subsection does not restrict the rights of:

(i) MIEMSS to obtain any information to which it is entitled under this subtitle; and

(ii) A hospital to information originating from the hospital's files.

(3) In a proceeding before an administrative law judge or a court:

(a) MIEMSS may disclose information or present evidence that contains or might reveal confidential information if the information is relevant to the case; and

(b) If there is an objection, before the information is disclosed, the administrative law judge or court that is conducting the proceeding shall determine whether the information is confidential and, if it is, enter an order that it determines is appropriate to protect the confidentiality of the information.

(4) MIEMSS has the burden of proving, by a preponderance of the evidence, the grounds for suspension, revocation, lowered level of designation, or probation.

(5) Except for an emergency suspension or revocation under §F of this regulation, not later than 60 business days after the close of the hearing, OAH shall issue a proposed decision that shall include proposed findings of fact and conclusions of law and a proposed order.

H. Appeal to the EMS Board.

(1) This section does not apply to an emergency revocation or suspension under §F of this regulation.

(2) Filing of Exceptions.

(a) Not later than 15 business days from the date it receives the proposed decision, a party aggrieved by the proposed decision may appeal by filing written exceptions with the Executive Director, for consideration by the EMS Board.

(b) The exceptions shall state with specificity the reasons why the proposed decision should be overturned.

(c) A party filing exceptions may request an oral argument and shall submit the request with the exceptions.

(d) A party filing exceptions shall mail a copy of its exceptions to the opposing party by first class mail, postage prepaid.

(e) If exceptions are not filed within the specified time period, the proposed decision is the final agency decision.

(f) Response to Exceptions.

(i) Not later than 15 business days from the date of the filing of the exceptions with the EMS Board, the opposing party may file a response with the EMS Board.

(ii) A party filing a response may request an oral argument and shall submit the request with the response.

(iii) A party filing a response shall mail a copy of its response to the party filing exceptions by first class mail, postage prepaid.

(3) Decision of EMS Board.

(a) The EMS Board may, in its discretion, rule on the exceptions with or without oral argument.

(b) If the EMS Board denies the exceptions, in whole or in part, the proposed decision is the final agency decision.

(c) If the EMS Board grants the exceptions, the EMS Board shall modify the proposed decision accordingly and the modified decision is the final agency decision.

(d) The EMS Board shall issue its final decision in accordance with State Government Article, §§10-220 and 10- 221, Annotated Code of Maryland.

I. A party aggrieved by a final agency decision of the EMS Board may seek judicial review in accordance with State Government Article, §10-222, Annotated Code of Maryland, and the Maryland Rules of Civil Procedure.