Amendment to Uniform Treatment Plan Form Regulations

BULLETIN 06-5 To: Private Review Agents Re: Amendment to Uniform Treatment Plan Form Regulations COMAR 31.10.21 Date: March 27, 2006 Purpose and Applicability The purpose of this Bulletin is to announce that the Uniform Treatment Plan Form required to be used by COMAR 31.10.21.02-1H has been amended. The Uniform Treatment Plan Form is the form that health care providers use when seeking approval to provide treatment for a mental illness, an emotional disorder or a substance abuse disorder. After consultation with representatives of the insurance and health care industry, the new form was developed to improve and streamline the provision of essential information by health care providers to Private Review Agents. The notice of final action on the amended Regulation and new Uniform Treatment Plan Form were published in the January 20, 2006 issue of the Maryland Register with an effective date of January 30, 2006. Health care providers may begin submitting health care treatment plan information and Private Review Agents must accept the new Uniform Treatment Plan Form as of that date. Background A Private Review Agent, as defined by Title 15, Subtitle 10B “Private Review Agents” of the Insurance Article, is required by Title 15, Subtitle 10B to accept the State of Maryland Uniform Treatment Plan Form to conduct utilization review of proposed or delivered services for the treatment of a mental illness, emotional disorder, or a substance abuse disorder. The uniform treatment plan form does not apply to a person or entity that uses a treatment plan form solely for internal purposes. R. STEVEN ORR Commissioner JAMES V. MCMAHAN, III Deputy Commissioner P. TODD CIONI Associate Commissioner Compliance & Enforcement ROBERT L. EHRLICH, JR. Governor MICHAEL S. STEELE Lt. Governor 525 St. Paul Place, Baltimore, Maryland 21202-2272 Direct Dial: 410-468-2235 Fax: 410-468-2204 Email: tcioni@mdinsurance.state.md.us 1-800-492-6116 TTY: 1-800-735-2258 www.mdinsurance.state.md.us 2 Code of Maryland Regulations (“COMAR”) 31.10.21 “Private Review Agents” provides additional instruction on form use and completion. For your convenience, a copy of the new Uniform Treatment Plan Form is attached to this Bulletin. An electronic version of the form is available on the MIA’s website at www.mdinsurance.state.md.us and is accessible by selecting Insurer Services then Other Related Services then the Health Care Provider Page. Questions about this bulletin may be directed to Thomas Marshall at (410) 468-2217. R. STEVEN ORR INSURANCE COMMISSIONER Signature on file with original ____________________________________ By: P. Todd Cioni, Associate Commissioner Compliance and Enforcement Maryland Insurance Administration