<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.67.12.05" title_num="10" subtitle_num="67" chapter_num="12" heading="Enrollee Appeal.">
  <paragraph num="A.">
    <text>An enrollee shall have 20 days to appeal an MCO’s determination of benefit abuse.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Except for the time frame specified in §A of this regulation, an appeal shall be handled as specified in COMAR 10.67.09.05.</text>
  </paragraph>
  <paragraph num="C.">
    <text>If the appeal results in a hearing, an MCO shall:</text>
    <paragraph num="(1)">
      <text>Attend the hearing; and</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Provide justification for enrollment in the program.</text>
    </paragraph>
  </paragraph>
</regulation>