Physician Rating Systems - Annual Reporting Requirement

BULLETIN 15-08 To: Insurers, Nonprofit Health Service Plans, and Health Maintenance Organizations (“Carriers”) Re: Physician Rating Systems—Annual Reporting Requirement Date: April 24, 2015 The purpose of this Bulletin is to remind carriers that utilize a physician rating system of the annual filing requirement in Insurance Article, § 15-1704(c) of the Annotated Code of Maryland. Carriers that do not use a physician rating system are not required to make a filing. A physician rating system is a program that (1) measures, rates, or tiers the performance of physicians under contract with the carrier; and (2) discloses the measures, rates, or tiers to enrollees or the public.1 Section 15-1704(c) of the Insurance Article requires that a carrier using a physician rating system report annually to the Commissioner: 1. The number of appeals filed by physicians under Title 15, Subtitle 17 of the Insurance Article; and 2. The outcome of the appeals. The report should be submitted to the Commissioner annually on October 1 and should include the information described above for appeals filed by physicians between July 1 of the prior year through June 30 of the current year. Questions about this Bulletin may be directed to the Life/Health Section of the Maryland Insurance Administration at 410-468-2170. Brenda A. Wilson Associate Commissioner Life and Health 1 See § 15-1701(d), Insurance Article. AL REDMER, JR. Commissioner NANCY GRODIN Deputy Commissioner LARRY HOGAN Governor BOYD K. RUTHERFORD Lt. Governor 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 1-800-492-6116 TTY: 1-800-735-2258 www.insurance maryland.gov Signature on original