3372                                          LAWS OF MARYLAND                                     Ch. 726

477CC.

(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE
MEANINGS INDICATED.

(2) "PREFERRED PROVIDER POLICIES OR PREFERRED
PROVIDER CONTRACTS" MEANS INSURANCE POLICIES OR INSURANCE
CONTRACTS WHICH SPECIFY THE SERVICES AND HOW SERVICES ARE TO BE
COVERED WHEN RENDERED BY PREFERRED AND NONPREFERRED PROVIDERS.

(3) "PREFERRED PROVIDER" MEANS A PROVIDER WHO HAS
CONTRACTED WITH AN INSURER TO MEET THE TERMS AND CONDITIONS
OFFERED IN THE PREFERRED PROVIDER POLICY OR PREFERRED PROVIDER
CONTRACT.

(4) "PROVIDER" MEANS ANY PERSON, INCLUDING A
PHYSICIAN OR HOSPITAL, WHO IS LICENSED OR OTHERWISE AUTHORIZED TO
PROVIDE HEALTH CARE SERVICES, WITHIN THE SCOPE OF THE LICENSE OR
AUTHORIZATION.

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

(6) "UNFAIR DISCRIMINATION" MEANS ANY ACT, METHOD OF
COMPETITION, OR PRACTICE ENGAGED IN BY AN INSURER, WHICH IS
PROHIBITED BY SECTIONS 217 THROUGH 234, INCLUSIVE, OF THIS
SUBTITLE OR ANY ACT, METHOD OF COMPETITION, OR PRACTICE NOT
SPECIFIED IN SECTIONS 217 THROUGH 234, INCLUSIVE, THAT THE
COMMISSIONER BELIEVES IS UNFAIR OR DECEPTIVE AND WHICH RESULTS IN
THE INSTITUTION OF AN ACTION BY THE COMMISSIONER UNDER SECTION
216 OF THIS SUBTITLE.

(B) (1) SUBJECT TO THE APPROVAL OF THE COMMISSIONER, AN
INSURER MAY OFFER OR ADMINISTER A HEALTH BENEFIT PROGRAM UNDER
WHICH THE INSURER MAY OFFER PREFERRED PROVIDER POLICIES OR
PREFERRED PROVIDER CONTRACTS THAT LIMIT THE NUMBERS AND TYPES OF
PROVIDERS OF HEALTH CARE SERVICES ELIGIBLE FOR PAYMENT AS
PREFERRED PROVIDERS UNDER THE INSURANCE POLICIES OR INSURANCE
CONTRACTS.

(2) AN INSURER MAY ESTABLISH TERMS AND CONDITIONS
THAT SHALL BE MET BY A PROVIDER IN ORDER TO QUALIFY FOR PAYMENT
AS A PREFERRED PROVIDER UNDER THE INSURANCE POLICIES OR INSURANCE
CONTRACTS.

(3) A PROVIDER THAT AGREES TO THE TERMS AND
CONDITIONS OFFERED BY THE INSURER UNDER THE TERMS OF THE
PREFERRED PROVIDER CONTRACT OR POLICY MAY NOT BE EXCLUDED.

(4) THE TERMS AND CONDITIONS OF PREFERRED PROVIDER
POLICIES OR CONTRACTS MAY NOT UNFAIRLY DISCRIMINATE AGAINST OR
AMONG HEALTH CARE PROVIDERS.