<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".06" citation="COMAR 30.08.13.06" title_num="30" subtitle_num="08" chapter_num="13" heading="Procedures for Disciplinary Actions.">
  <paragraph num="A.">
    <text>MIEMSS shall initiate an action to place a trauma or specialty referral center on probation or to lower, suspend, or revoke a trauma or specialty referral center's designation if MIEMSS:</text>
    <paragraph num="(1)">
      <text>Determines that the violation warrants probation, lowered level of designation, suspension, or revocation; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Has required a plan of corrective action, and:</text>
      <paragraph num="(a)">
        <text>The trauma or specialty referral center fails to submit a plan within the time set by MIEMSS, or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>MIEMMS determines that the trauma or specialty referral center has not satisfactorily complied with the plan.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>Notice of Action.</text>
    <paragraph num="(1)">
      <text>MIEMSS shall notify a trauma or specialty referral center of the disciplinary action by issuing a written notice of suspension, revocation, lowered level of designation, or probation to the chief executive officer of the hospital.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The notice of suspension, revocation, lowered level of designation, or probation shall conform to State Government Article, §10-207, Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>MIEMSS shall notify the EMS Board of the action taken.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>Except in the case of an emergency suspension or revocation under §F of this regulation, the suspension, revocation, lowered level of designation, or probation is stayed pending the final agency decision.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Informal Meeting.</text>
    <paragraph num="(1)">
      <text>Not later than 15 business days from the date a trauma or specialty referral center receives a notice of suspension, revocation, lowered level of designation, or probation, the trauma or specialty referral center may request, in writing, an informal meeting with MIEMSS to discuss MIEMSS' action.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The meeting shall be held not later than 10 business days from the date MIEMSS receives the request.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>If the trauma or specialty referral center does not timely request an informal meeting, MIEMSS' notice of suspension, revocation, lowered level of designation, or probation is the final agency decision.</text>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>Request for Hearing.</text>
    <paragraph num="(1)">
      <text>This section does not apply to an emergency revocation or suspension hearing under §F of this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>If the trauma or specialty referral center is not satisfied with the result of the informal meeting, not later than 15 business days from the date of the meeting, it may request a hearing by sending a written request for a hearing by certified mail, return receipt requested, addressed to the MIEMSS Office of Hospital Programs in Baltimore, Maryland.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Not later than 5 business days from the date of receipt of a timely request for a hearing, MIEMSS shall forward the request to OAH.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>From the date OAH receives the hearing request, OAH shall schedule a hearing as soon as practicable for all parties and OAH, but not later than:</text>
      <paragraph num="(a)">
        <text>60 calendar days for temporary suspensions or revocations; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>90 calendar days for all other hearings.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>The hearing is conducted in accordance with the procedures set forth in §G of this regulation.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>If the trauma or specialty referral center does not request a hearing in a timely manner, MIEMSS' notice of suspension, revocation, lowered level of designation, or probation is the final agency decision.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>Emergency Revocation or Suspension.</text>
    <paragraph num="(1)">
      <text>If MIEMSS determines that grounds exist that require immediate suspension or revocation of designation for the public's protection, MIEMSS may issue a notice of immediate suspension or revocation of designation to the chief executive officer of the trauma or specialty referral center.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The suspension or revocation of designation is effective immediately upon service of the notice of immediate suspension or revocation of designation.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Request for Hearing.</text>
      <paragraph num="(a)">
        <text>Not later than 15 business days after service of the notice of immediate suspension or revocation of designation, the trauma or specialty referral center may request a hearing by sending a written request for a hearing by certified mail, return receipt requested, addressed to the MIEMSS Office of Hospital Programs in Baltimore, Maryland.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Requesting a hearing does not negate, or act as a stay of, the suspension or revocation.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>If the trauma or specialty referral center does not request a hearing in a timely manner, MIEMSS' notice of immediate suspension or revocation of designation is the final agency decision.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>Upon receipt of a hearing request, MIEMSS shall send a written request to OAH to schedule a hearing.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>OAH shall conduct the hearing within 10 business days of the date it receives the hearing request, except that the time period may be extended by:</text>
      <paragraph num="(a)">
        <text>OAH for good cause; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Agreement of the trauma or specialty referral center and MIEMSS.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(6)">
      <text>Except as modified in this section, the hearing shall be conducted in accordance with the procedures set forth in §G of this regulation.</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Not later than 10 business days after the close of the hearing record, OAH shall issue a proposed decision that includes proposed findings of fact and conclusions of law and a proposed order, except that the time period may be extended by:</text>
      <paragraph num="(a)">
        <text>OAH for good cause; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Agreement of the trauma or specialty referral center and MIEMSS.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>Appeal to the EMS Board.</text>
      <paragraph num="(a)">
        <text>Filing of Exceptions.</text>
        <paragraph num="(i)">
          <text>Not later than 5 business days from the date it receives the proposed decision, a party aggrieved by the proposed decision may appeal by filing written exceptions with the Executive Director, for consideration by the EMS Board.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The exceptions shall state with specificity the reasons why the proposed decision should be overturned.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A party filing exceptions may request an oral argument and shall submit the request with the exceptions.</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A party filing exceptions shall mail a copy of its exceptions to the opposing party by first class mail, postage prepaid.</text>
        </paragraph>
        <paragraph num="(v)">
          <text>If exceptions are not filed within the specified time period, the OAH proposed decision is the final agency decision.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>Response to Exceptions.</text>
        <paragraph num="(i)">
          <text>Not later than 5 business days after the opposing party receives a copy of the exceptions, the opposing party may file a response with the EMS Board.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A party filing a response may request an oral argument and shall submit the request with the response.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A party filing a response shall mail a copy of its response to the party filing exceptions by first class mail, postage prepaid.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(c)">
        <text>Decision of EMS Board.</text>
        <paragraph num="(i)">
          <text>Not later than 30 calendar days after the filing of the exceptions or the response, whichever is later, the EMS Board shall issue a written decision granting or denying the exceptions.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>The EMS Board may, in its discretion, rule on the exceptions with or without oral argument.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(d)">
        <text>If the EMS Board denies the exceptions, the proposed decision, as affirmed by the EMS Board, is the final agency decision.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>If the EMS Board grants the exceptions, in whole or in part, the EMS Board shall modify the proposed decision accordingly and the modified decision is the final agency decision.</text>
      </paragraph>
      <paragraph num="(f)">
        <text>The EMS Board shall issue its final decision in accordance with State Government Article, §§10-220 and 10- 221, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(9)">
      <text>A party aggrieved by a final agency decision may seek judicial review in accordance with State Government Article, §10-222, Annotated Code of Maryland, and the Maryland Rules of Civil Procedure.</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Hearing Procedures.</text>
    <paragraph num="(1)">
      <text>A hearing shall be conducted in accordance with the procedures and regulations of OAH set forth in COMAR 28.02.01, except as modified by this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Confidential Materials Not Discoverable.</text>
      <paragraph num="(a)">
        <text>In addition to the restrictions on discovery of documents under COMAR 28.02.01.10, a party is not entitled to discovery of any confidential:</text>
        <paragraph num="(i)">
          <text>Record;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>File;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>Memorandum;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>Correspondence;</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Document;</text>
        </paragraph>
        <paragraph num="(vi)">
          <text>Object; or</text>
        </paragraph>
        <paragraph num="(vii)">
          <text>Other tangible thing.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>For purposes of this regulation, all records, files, memoranda, correspondence, documents, objects, other tangible things, notes, minutes of conferences, and any other communications of members of an on-site review team are confidential.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>This subsection does not restrict the rights of:</text>
        <paragraph num="(i)">
          <text>MIEMSS to obtain any information to which it is entitled under this subtitle; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A hospital to information originating from the hospital's files.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>In a proceeding before an administrative law judge or a court:</text>
      <paragraph num="(a)">
        <text>MIEMSS may disclose information or present evidence that contains or might reveal confidential information if the information is relevant to the case; and</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If there is an objection, before the information is disclosed, the administrative law judge or court that is conducting the proceeding shall determine whether the information is confidential and, if it is, enter an order that it determines is appropriate to protect the confidentiality of the information.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(4)">
      <text>MIEMSS has the burden of proving, by a preponderance of the evidence, the grounds for suspension, revocation, lowered level of designation, or probation.</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Except for an emergency suspension or revocation under §F of this regulation, not later than 60 business days after the close of the hearing, OAH shall issue a proposed decision that shall include proposed findings of fact and conclusions of law and a proposed order.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Appeal to the EMS Board.</text>
    <paragraph num="(1)">
      <text>This section does not apply to an emergency revocation or suspension under §F of this regulation.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Filing of Exceptions.</text>
      <paragraph num="(a)">
        <text>Not later than 15 business days from the date it receives the proposed decision, a party aggrieved by the proposed decision may appeal by filing written exceptions with the Executive Director, for consideration by the EMS Board.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The exceptions shall state with specificity the reasons why the proposed decision should be overturned.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>A party filing exceptions may request an oral argument and shall submit the request with the exceptions.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>A party filing exceptions shall mail a copy of its exceptions to the opposing party by first class mail, postage prepaid.</text>
      </paragraph>
      <paragraph num="(e)">
        <text>If exceptions are not filed within the specified time period, the proposed decision is the final agency decision.</text>
      </paragraph>
      <paragraph num="(f)">
        <text>Response to Exceptions.</text>
        <paragraph num="(i)">
          <text>Not later than 15 business days from the date of the filing of the exceptions with the EMS Board, the opposing party may file a response with the EMS Board.</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A party filing a response may request an oral argument and shall submit the request with the response.</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A party filing a response shall mail a copy of its response to the party filing exceptions by first class mail, postage prepaid.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(3)">
      <text>Decision of EMS Board.</text>
      <paragraph num="(a)">
        <text>The EMS Board may, in its discretion, rule on the exceptions with or without oral argument.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>If the EMS Board denies the exceptions, in whole or in part, the proposed decision is the final agency decision.</text>
      </paragraph>
      <paragraph num="(c)">
        <text>If the EMS Board grants the exceptions, the EMS Board shall modify the proposed decision accordingly and the modified decision is the final agency decision.</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The EMS Board shall issue its final decision in accordance with State Government Article, §§10-220 and 10- 221, Annotated Code of Maryland.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="I.">
    <text>A party aggrieved by a final agency decision of the EMS Board may seek judicial review in accordance with State Government Article, §10-222, Annotated Code of Maryland, and the Maryland Rules of Civil Procedure.</text>
  </paragraph>
</regulation>