Ch. 578 LAWS OF MARYLAND
$1,000 for failure to comply with this section.]

SUBTITLE 49. PREFERRED PROVIDER ORGANIZATIONS

650.

(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE
MEANINGS INDICATED.

(B) "INSURED" MEANS A PARTICIPANT IN, SUBSCRIBER TO, OR
BENEFICIARY OF A PREFERRED PROVIDER INSURANCE POLICY
OFFERED OR ADMINISTERED BY AN INSURER.

(C) (1) "INSURER" MEANS ANY FOR PROFIT, NONPROFIT, OR
MUTUAL INSURER OR HEALTH SERVICE PLAN THAT ISSUES OR
DELIVERS IN THIS STATE ANY POLICY OF HEALTH INSURANCE,
WHETHER ON A GROUP OR INDIVIDUAL BASIS, UNDER SUBTITLES 20, 25,
OR 26 OF THIS ARTICLE.

(3) "INSURER" DOES NOT INCLUDE CAPITATED DENTAL

(D) "NONPREFERRED PROVIDER" MEANS A PROVIDER ELIGIBLE
FOR PAYMENT UNDER A PREFERRED PROVIDER INSURANCE POLICY,
WHO IS NOT A CONTRACTEE UNDER THE PROVISIONS OF THE
APPLICABLE PROVIDER SERVICE CONTRACT.

(E) "PREFERENTIAL BASIS" MEANS THAT THE INSURED OR THE
SUBSCRIBER UNDER A PREFERRED PROVIDER INSURANCE POLICY IS
ENTITLED TO RECEIVE HEALTH CARE SERVICES FROM PREFERRED
PROVIDERS AT NO COST, AT A REDUCED FEE, OR UNDER MORE
FAVORABLE TERMS THAN WOULD BE THE CASE IF THE INSURED OR THE
SUBSCRIBER RECEIVED SIMILAR SERVICES FROM A NONPREFERRED
PROVIDER.

(F) "PREFERRED PROVIDER" MEANS A PROVIDER THAT HAS
ENTERED INTO A PROVIDER SERVICE CONTRACT WITH:

(1) AN INSURER; OR

(2) AN EMPLOYER, ADMINISTRATOR, OR OTHER ENTITY
OFFERING A PREFERRED PROVIDER INSURANCE POLICY TO A
SUBSCRIBER.

(G) "PREFERRED PROVIDER INSURANCE POLICY" MEANS ANY:

(1) INSURANCE POLICY OR INSURANCE CONTRACT ISSUED OR
DELIVERED IN THIS STATE BY AN INSURER THAT SPECIFIES THAT
HEALTH SERVICES COVERED UNDER THE POLICY OR CONTRACT ARE TO
BE PROVIDED TO THE INSURED BY A PREFERRED PROVIDER ON A
PREFERENTIAL BASIS; OR

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