Section 19-132 - Definitions.

§ 19-132. Definitions.
 

(a)  In general.- In this Part III of this subtitle the following words have the meanings indicated. 

(b)  Ambulatory surgical facility.- "Ambulatory surgical facility" has the meaning stated in § 19-3B-01 of this title. 

(c)  Comprehensive standard health benefit plan.- "Comprehensive standard health benefit plan" means the comprehensive standard health benefit plan adopted in accordance with § 15-1207 of the Insurance Article. 

(d)  Health care practitioner.- "Health care practitioner" means any individual who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care services. 

(e)  Health care provider.-  

(1) "Health care provider" means: 

(i) A person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or 

(ii) A facility where health care is provided to patients or recipients, including: 

1. A facility, as defined in § 10-101(e) of this article; 

2. A hospital, as defined in § 19-301 of this title; 

3. A related institution, as defined in § 19-301 of this title; 

4. A health maintenance organization, as defined in § 19-701(g) of this title; 

5. An outpatient clinic; and 

6. A medical laboratory. 

(2) "Health care provider" includes the agents and employees of a facility who are licensed or otherwise authorized to provide health care, the officers and directors of a facility, and the agents and employees of a health care provider who are licensed or otherwise authorized to provide health care. 

(f)  Health care service.- "Health care service" means any health or medical care procedure or service rendered by a health care practitioner that: 

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

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

(g)  Hospital.- "Hospital" has the meaning stated in § 19-301 of this title. 

(h)  Mandated health insurance service.-  

(1) "Mandated health insurance service" means a legislative proposal or statute that would require a particular health care service to be provided or offered in a health benefit plan, by a carrier or other organization authorized to provide health benefit plans in the State. 

(2) "Mandated health insurance service", as applicable to all carriers, does not include services enumerated to describe a health maintenance organization under § 19-701(g)(2) of this title. 

(i)  Nursing facility.- "Nursing facility" has the meaning stated in § 19-1401 of this title. 

(j)  Office facility.-  

(1) "Office facility" means the office of one or more health care practitioners in which health care services are provided to individuals. 

(2) "Office facility" includes a facility that provides: 

(i) Ambulatory surgery; 

(ii) Radiological or diagnostic imagery; or 

(iii) Laboratory services. 

(3) "Office facility" does not include any office, facility, or service operated by a hospital and regulated under Part II of this subtitle. 

(k)  Payor.- "Payor" means: 

(1) A health insurer or nonprofit health service plan that holds a certificate of authority and provides health insurance policies or contracts in the State in accordance with this article or the Insurance Article; 

(2) A health maintenance organization that holds a certificate of authority in the State; or 

(3) For the purposes of this Part III of this subtitle only, a person that is registered as an administrator under Title 8, Subtitle 3 of the Insurance Article. 
 

[1993, ch. 9, § 1; 1994, ch. 3, § 1; ch. 258, § 1; 1995, ch. 462; 1997, ch. 14, § 20; ch. 70, § 4; ch. 134, § 1; 1999, ch. 34, § 7; ch. 382, § 2; ch. 383, § 2; chs. 582, 657; ch. 702, § 2; 2000, ch. 61, § 1; 2001, ch. 565, § 2; 2003, ch. 21, § 6; 2004, ch. 25, §§ 1, 6; 2007, ch. 5, § 7.]