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§ 19-7A-01. Definitions

West's Annotated Code of MarylandHealth--General

West's Annotated Code of Maryland
Health--General
Title 19. Health Care Facilities (Refs & Annos)
Subtitle 7a. Provider-Sponsored Organizations (Refs & Annos)
MD Code, Health - General, § 19-7A-01
§ 19-7A-01. Definitions
Currentness
In general
(a) In this subtitle the following words have the meanings indicated.
Commissioner
(b) “Commissioner” means the Maryland Insurance Commissioner.
Health care services
(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.
License
(d) “License” includes a certificate of authority, as defined in § 1-101 of the Insurance Article.
Provider
(e) “Provider” means any person, including a physician or hospital, that is licensed or otherwise authorized in this State to provide health care services.
Provider-sponsored organization
(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.

Credits

Added by Acts 1998, c. 213, § 1, eff. June 1, 1998.
MD Code, Health - General, § 19-7A-01, MD HEALTH GEN § 19-7A-01
Current through legislation effective through May 9, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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