§ 19-7A-01

Maryland § 19-7A-01

• Jurisdiction: Maryland
• Article ghg: Health - General
• Title: 19

Text

(a) In this subtitle the following words have the meanings indicated.

(b) “Commissioner” means the Maryland Insurance Commissioner.

(c) “Health care services” means a health or medical care procedure or service rendered by a health care provider that:

(1) Provides testing, diagnosis, or treatment of a human disease or dysfunction; or

(2) Dispenses drugs, medical devices, medical appliances, or medical goods for the treatment of a human disease or dysfunction.

(d) “License” includes a certificate of authority, as defined in § 1-101 of the Insurance Article.

(e) “Provider” means any person, including a physician or hospital, that is licensed or otherwise authorized in this State to provide health care services.

(f) “Provider-sponsored organization” means an entity that:

(1) Is a legal aggregation of providers operating collectively for the purpose of providing health care services to Medicare beneficiaries under the federal Medicare+Choice Program;

(2) Acts through a licensed entity, such as a partnership, corporation, limited liability company, limited liability partnership, or sole proprietorship, that has authority over the entity’s activities and responsibility for satisfying the requirements of § 19-7A-02 of this subtitle; and

(3) Provides a substantial proportion of the health care services required to be provided under the federal Medicare+Choice Program directly through providers or affiliated groups of providers.