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1993 LAWS OF MARYLAND
1-304.
(A) A HEALTH CARE PRACTITIONER SHALL DISCLOSE THE NAME OF A
REFERRING HEALTH CARE PRACTITIONER ON EACH REQUEST FOR PAYMENT OR
BILL SUBMITTED TO A THIRD PARTY PAYOR, INCLUDING NONPROFIT HEALTH -
PLANS AND FISCAL INTERMEDIARIES AND CARRIERS, THAT MAY BE RESPONSIBLE
FOR PAYMENT, IN WHOLE OR IN PART, OF THE CHARGES FOR A HEALTH CARE
SERVICE, IF THE HEALTH CARE PRACTITIONER KNOWS OR HAS REASON TO
BELIEVE:
(1) THERE HAS BEEN A REFERRAL BY A HEALTH CARE PRACTITIONER;
AND
(2) THE REFERRING HEALTH CARE PRACTITIONER HAS A BENEFICIAL
INTEREST IN OR COMPENSATION ARRANGEMENT WITH THE HEALTH CARE ENTITY
THAT IS PROHIBITED UNDER § 1-302 OF THIS SUBTITLE.
(B) A HEALTH CARE PRACTITIONER WHO KNOWS OR SHOULD HAVE KNOWN
OF THE PRACTITIONER'S FAILURE TO COMPLY WITH THE PROVISIONS OF THIS
SECTION SHALL BE SUBJECT TO DISCIPLINARY ACTION BY THE APPROPRIATE
LICENSING BOARD.
1-305.
(A) IF A REFERRING HEALTH CARE PRACTITIONER, A HEALTH CARE ENTITY,
OR OTHER PERSON FURNISHING HEALTH CARE SERVICES COLLECTS ANY AMOUNT
OF MONEY THAT WAS BILLED IN VIOLATION OF § 1-302(B) OF THIS SUBTITLE AND
THE REFERRING HEALTH CARE PRACTITIONER, HEALTH CARE ENTITY, OR OTHER
PERSON KNEW OR SHOULD HAVE KNOWN OF THE VIOLATION, THE REFERRING
HEALTH CARE PRACTITIONER, HEALTH CARE ENTITY, OR OTHER PERSON IS
JOINTLY AND SEVERALLY LIABLE TO THE PAYOR FOR ANY AMOUNTS COLLECTED.
(B) IF A CLAIM, BILL, OR OTHER DEMAND OR REQUEST FOR PAYMENT FOR
HEALTH CARE SERVICES IS DENIED UNDER § 19-712.4 OF THE HEALTH - GENERAL
ARTICLE OR § 354MM, § 470CC, OR § 477MM OF ARTICLE 48A OF THE CODE, THE
REFERRING HEALTH CARE PRACTITIONER, HEALTH CARE ENTITY, OR OTHER
PERSON FURNISHING THE HEALTH CARE SERVICES MAY NOT SUBMIT A CLAIM, BILL,
OR OTHER DEMAND OR REQUEST FOR PAYMENT TO THE PERSON WHO RECEIVED
THE HEALTH CARE SERVICES.
1-306.
A HEALTH CARE PRACTITIONER WHO FAILS TO COMPLY WITH THE
PROVISIONS OF THIS SUBTITLE SHALL BE SUBJECT TO DISCIPLINARY ACTION BY THE
APPROPRIATE REGULATORY BOARD.
- 2078 -
Ch. 376
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