(a) The person subject to the medical quality review
process has the right:
(1) to be notified that the person has been selected
for the medical quality review process;
(2) to be notified of the disposition of the medical
quality review process;
(3) to communicate with the office of the medical advisor
at any time during the medical quality review process;
(4) to be represented by legal counsel, including legal
counsel at the informal settlement conference (ISC);
(5) to receive written notice of an ISC at least 45
days before the ISC, including the time and place of the ISC and the
nature of the allegations; and
(6) to an ISC in accordance with the provisions of
this section. The ISC provides persons subject to the medical quality
review process an opportunity to discuss and resolve their medical
case review with arbiters. The division may, at its discretion, conduct
an ISC remotely or in person. An ISC is available under the following
conditions:
(A) The case has been referred to enforcement.
(B) The request for an ISC must be in writing.
(C) The division will notify the requester of the scheduled
date of the ISC.
(D) The requester has the right to receive copies of
all documents that pertain to the substance of the case and that were
given to the arbiters for review for that particular case.
(E) All information the requester wishes the arbiters
to consider at the ISC must be received by the division no later than
15 days before the ISC. The arbiters may refuse to consider any information
not timely received by the division.
(F) The requester may request to reschedule the scheduled
date of the ISC for good cause shown, in writing, as determined by
the division's presiding attorney. Good cause means circumstances
beyond the requester's control that reasonably prevent the requester
from attending the ISC and requesting that the ISC be rescheduled
any sooner.
(G) If a requester fails to attend an ISC as scheduled,
the requester loses the right to an ISC. But failure to attend the
ISC does not affect the requester's rights to:
(i) communicate with the office of the medical advisor
as paragraph (3) of this subsection provides;
(ii) enter into a consent order with the division;
or
(iii) defend an enforcement case at the State Office
of Administrative Hearings.
(b) A person subject to a medical case review must:
(1) provide records and information requested from
the office of the medical advisor in the format and manner specified
by the division;
(2) provide the records and information within the
time period specified in the request; and
(3) attach an accurate and completed business records
affidavit to the request for records and information.
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