|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
PARRIS N. GLENDENING, Governor
|
|
|
|
|
|
S.B. 164
|
|
|
|
|
|
|
|
|
|
|
|
|
|
(G) (1) "HEALTH BENEFIT PLAN" MEANS:
(I) A HOSPITAL OR MEDICAL POLICY OR CONTRACT, INCLUDING A
POLICY OR CONTRACT ISSUED UNDER A MULTIPLE EMPLOYER TRUST OR
ASSOCIATION;
(II) A HOSPITAL OR MEDICAL POLICY OR CONTRACT ISSUED BY A
NONPROFIT HEALTH SERVICE PLAN;
(III) A HEALTH MAINTENANCE ORGANIZATION CONTRACT; OR
(IV) A DENTAL PLAN ORGANIZATION CONTRACT.
(2) "HEALTH BENEFIT PLAN" DOES NOT INCLUDE ONE OR MORE, OR ANY
COMBINATION OF THE FOLLOWING:
(I) LONG-TERM CARE INSURANCE;
(II) DISABILITY INSURANCE;
(III) ACCIDENTAL TRAVEL AND ACCIDENTAL DEATH AND
DISMEMBERMENT INSURANCE;
(IV) CREDIT HEALTH INSURANCE;
(V) A HEALTH BENEFIT PLAN ISSUED BY A MANAGED CARE
ORGANIZATION, AS DEFINED IN TITLE 15, SUBTITLE 1 OF THE HEALTH - GENERAL
ARTICLE;
(VI) DISEASE-SPECIFIC INSURANCE; OR
(VII) FIXED INDEMNITY INSURANCE.
(H) "HEALTH CARE PROVIDER" MEANS:
(I) AN INDIVIDUAL WHO IS LICENSED UNDER THE HEALTH
OCCUPATIONS ARTICLE TO PROVIDE HEALTH CARE SERVICES IN THE ORDINARY
COURSE OF BUSINESS OR PRACTICE OF A PROFESSION AND IS A TREATING PROVIDER
OF THE MEMBER; OR
(2) A HOSPITAL, AS DEFINED IN § 19-301 OF THE HEALTH - GENERAL
ARTICLE.
(H) (I) "HEALTH CARE SERVICE" 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.
(I) (J) (1) "MEMBER" MEANS A PERSON ENTITLED TO HEALTH CARE
BENEFITS SERVICES UNDER A POLICY, PLAN, OR CERTIFICATE CONTRACT ISSUED OR
DELIVERED IN THE STATE BY A CARRIER
|
|
|
|
|
|
|
|
|
|
- 3735 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
