<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".04" citation="COMAR 10.25.19.04" title_num="10" subtitle_num="25" chapter_num="19" heading="Procedure for Initial State Recognition.">
  <paragraph num="A.">
    <text>Application.</text>
    <paragraph num="(1)">
      <text>An electronic advance directives service seeking State Recognition shall submit an application in the form and manner specified by the Commission.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The application, and all information supplementing the application, shall be signed by at least one person authorized by the applicant, who shall sign a statement as follows: “I solemnly affirm under penalties of perjury that the contents of this application (or the supplementary information) are true to the best of my knowledge, information, and belief.”</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>An electronic advance directives service seeking State Recognition shall:</text>
    <paragraph num="(1)">
      <text>Demonstrate that it meets all State Recognition criteria in effect at the date of the Commission's receipt of the initial application;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Affirm under penalties of perjury that, within the last 10 years, no current or former owner or senior manager of the service or a current or former owner or senior manager of any related or affiliated service has:</text>
      <paragraph num="(a)">
        <text>Been convicted of a felony or pleaded guilty, nolo contendere, entered a best interest plea of guilty, or received a diversionary disposition regarding a felony;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Received a determination of exclusion from participation in Medicare or State health care programs under 42 U.S.C. §1320a-7 in any case with respect to a criminal or civil charge of Medicare or Medicaid fraud or abuse; or</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Been found in violation of State or federal laws or regulations that govern the operation of, or relate in any way to, an electronic advance directives service;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Affirm under penalties of perjury that the service or any related or affiliated service:</text>
      <paragraph num="(a)">
        <text>Has no pending complaints, judgments, liens, or any final judgment or liens; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Has not been the subject of an investigation by or order of any local, State, or federal governmental agency;</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Provide all required documentation;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Timely provide additional information requested by Commission staff as needed to complete analysis of the application and make a recommendation to the Commission;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Send written notice to the Commission of any change in information submitted in the initial application within ten business days after the change is effective; and</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Agree to comply with the requirements of this chapter.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Review of Applications.</text>
    <paragraph num="(1)">
      <text>Commission staff shall:</text>
      <paragraph num="(a)">
        <text>Review an application to determine its compliance with State Recognition criteria; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Prepare a recommendation to the Commission on the application, detailing the reasons for the recommendation.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>If Commission staff recommends denial of an application for State Recognition:</text>
      <paragraph num="(a)">
        <text>An applicant has ten days after electronic delivery of the Commission staff's recommended denial in which to make a written filing taking exceptions to the staff's recommendation; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Each applicant that timely submits a written filing may present oral argument on its written exceptions to the Commission, not to exceed 10 minutes per applicant unless time is extended by the Chair of the Commission.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>The Commission may award State Recognition to each electronic advance directives service that meets all State Recognition criteria unless the Commission:</text>
      <paragraph num="(a)">
        <text>Determines that it is in the public interest to award State Recognition to fewer than all the electronic advance directives services that meet the qualifications for State Recognition; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Details the bases for its decision.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="D.">
    <text>Duration of State Recognition.</text>
    <paragraph num="(1)">
      <text>State Recognition is valid for three years from its issuance, unless suspended or revoked by the Commission.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An electronic advance directives service to which the Commission grants State Recognition shall acknowledge the status in writing and agree to comply with the terms and conditions of the award of State Recognition status.</text>
    </paragraph>
  </paragraph>
</regulation>