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ROBERT L. EHRLICH, JR., Governor Ch. 70
retaliation for cooperating with an investigation under certain circumstances;
prohibiting certain health care providers from taking retaliatory actions against
certain employees under certain circumstances; authorizing certain employees
to file civil actions against certain providers under certain circumstances;
limiting the length of time an employee may file a civil action under certain
circumstances; authorizing a court to take certain actions; requiring certain
providers to display certain notices and provide certain information in a certain
manner; requiring the Department to establish a task force to review certain
laws and regulations for certain purposes; requiring a certain report to be
submitted to certain committees; defining certain terms; and generally relating
to health program integrity and recovery activities.
BY adding to
Article - Health - General
Section 2-501 through 2-509 2-505, inclusive, to be under the new subtitle
"Subtitle 5. Health Program Integrity and Recovery Activities"
Annotated Code of Maryland
(2005 Replacement Volume and 2005 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That the Laws of Maryland read as follows:
Article - Health - General
SUBTITLE 5. HEALTH PROGRAM INTEGRITY AND RECOVERY ACTIVITIES.
2-501.
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(B) "ABUSE" MEANS PROVIDER PRACTICES THAT ARE INCONSISTENT WITH
SOUND FISCAL, BUSINESS, OR MEDICAL PRACTICES AND RESULT IN UNNECESSARY
COSTS TO A PROGRAM, OR IN REIMBURSEMENT FOR SERVICES THAT ARE NOT
MEDICALLY NECESSARY OR THAT FAIL TO MEET PROFESSIONALLY RECOGNIZED
HEALTH CARE STANDARDS.
(C) "CLAIM" MEANS A REQUEST OR DEMAND FOR MONEY, PROPERTY, OR
SERVICES MADE UNDER CONTRACT OR OTHERWISE, BY A CONTRACTOR, GRANTEE,
PROVIDER, OR OTHER PERSON SEEKING MONEY FOR THE PROVISION OF HEALTH
SERVICES IF:
(1) THE STATE OR DEPARTMENT PROVIDES ANY PORTION OF THE
MONEY OR PROPERTY THAT IS REQUESTED OR DEMANDED; OR
(2) THE STATE OR DEPARTMENT REIMBURSES THE CONTRACTOR,
GRANTEE, PROVIDER, OR OTHER PERSON FOR ANY PORTION OF THE MONEY OR
PROPERTY THAT IS REQUESTED OR DEMANDED.
(D) "CORPORATE COMPLIANCE PROGRAM" MEANS A FORMAL
ORGANIZATIONAL PROGRAM THAT.'
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