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Unannotated Code of Maryland (Last Updated: May 16, 2014) |
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CRIMINAL LAW |
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TITLE 8. FRAUD AND RELATED CRIMES |
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SUBTITLE 5. PUBLIC FRAUD |
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PART II. MEDICAID FRAUD |
§ 8-508. Definitions
Latest version.
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(a) In general. -- In this part the following words have the meanings indicated.
** REVISOR'S NOTE
This subsection formerly was Art. 27, § 230B(a).
** REVISOR'S NOTE
The reference to this "part" is substituted for the former reference to this "subheading" to reflect the reorganization of material derived from former Art. 27, § 230B through 230H.
** REVISOR'S NOTE
No other changes are made.
(b) False representation. -- "False representation" means the knowing and willful:
(1) concealing, falsifying, or omitting of a material fact;
(2) making of a materially false or fraudulent statement; or
(3) use of a document that contains a statement of material fact that the user knows to be false or fraudulent.
** REVISOR'S NOTE
This subsection is new language derived without substantive change from former Art. 27, § 230B(b).
(c) Health care service. --
(1) "Health care service" means health or medical care procedures, goods, or services that:
(i) provide testing, diagnosis, or treatment of human disease or dysfunction; or
(ii) dispense drugs, medical devices, medical appliances, or medical goods for the treatment of human disease or dysfunction.
(2) "Health care service" includes any procedure, goods, or service that is a required benefit of a State health plan.
** REVISOR'S NOTE
This subsection formerly was Art. 27, § 230B(c).
** REVISOR'S NOTE
No changes are made.
(d) Representation. -- "Representation" includes an acknowledgment, certification, claim, ratification, report of demographic statistics, encounter data, enrollment claims, financial information, health care services available or rendered, and qualifications of a person rendering health care or ancillary services.
** REVISOR'S NOTE
This subsection formerly was Art. 27, § 230B(d).
** REVISOR'S NOTE
No changes are made.
** DEFINED TERM:
"Person" § 1-101
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(e) Serious injury. -- "Serious injury" means an injury that: **
(1) creates a substantial risk of death; **
(2) causes serious permanent or serious protracted disfigurement; **
(3) causes serious permanent or serious protracted loss of the function of any body part, organ, or mental faculty; **
(4) causes serious permanent or serious protracted impairment of the function of any bodily member or organ; or **
(5) involves extreme physical pain.
REVISOR'S NOTE
This subsection formerly was Art. 27, § 230B(e).
REVISOR'S NOTE
No changes are made. **
(f) State health plan. -- **
(1) "State health plan" includes: **
(i) the State Medical Assistance Plan established in accordance with Title XIX of the federal Social Security Act of 1939; **
(ii) a medical assistance plan established by the State; or **
(iii) a private health insurance carrier, health maintenance organization, managed care organization as defined in § 15-101 of the Health - General Article, health care cooperative or alliance, or other person that provides or contracts to provide health care services that are wholly or partly reimbursed by or are a required benefit of a health plan established in accordance with Title XIX of the federal Social Security Act of 1939 or by the State. **
(2) "State health plan" includes a person that provides or contracts or subcontracts to provide health care services for an entity described in paragraph (1) of this subsection.
REVISOR'S NOTE
This subsection formerly was Art. 27, § 230B(f).
REVISOR'S NOTE
No changes are made.
"Person" § 1-101