§ 19-7A-01. Definitions  


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

    (b) Commissioner. -- "Commissioner" means the Maryland Insurance Commissioner.

    (c) Health care services. -- "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. -- "License" includes a certificate of authority, as defined in § 1-101 of the Insurance Article.

    (e) Provider. -- "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. -- "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.


HISTORY: 1998, ch. 213.