WILLIAM DONALD SCHAEFER, Governor                            Ch. 258

(d) Under the direction of the Commission, the executive director shall perform
any duty or function that the Commission requires.

19-1507.

(f) By October 1, 1995 and each year thereafter, the Commission shall publish an
annual report on those health care services selected by the Commission that:

(1)      Describes the variation in fees charged by [physicians] HEALTH CARE
PRACTITIONERS and office facilities on a statewide basis and in each health service area
for those health care services; and

(2)      Describes the geographic variation in the utilization of those health care
services.

(h) (1) If a physician's bill or request for payment for a physician's services includes
a charge to a patient for a diagnostic test for which payment may be made by a payor, the
amount payable with respect to the test shall be determined as follows:

(i) If the bill or request for payment indicates that the physician who
submitted the bill, or for whose services the request for payment was made, personally
performed or supervised the performance of the test or that another physician with whom the
physician shares the practice personally performed or supervised the test, the payment shall be
the reasonable charge for the test less the applicable deductible and coinsurance amounts; or

(ii) If the bill or request for payment indicates that the test was performed
by another provider or an office facility, identifies the provider or office facility, and indicates
the amount the provider or office facility charged the physician who submitted the bill or for
whose services the request for payment was made, payment for the test shall be the lower of:

1. The provider's or office facility's usual, customary and
reasonable charge for the test; or

2. The amount the provider or office facility charged the physician
for the test, plus a [nominal] fee NOT TO EXCEED $5, where the physician bills for such a
service, to cover the physician's costs in collecting and handling the sample on which the test
was performed less the applicable deductible and coinsurance amounts.

(2)     A payor may refuse payment of a bill, if the bill or request for a payment:

(i) As provided under paragraph (1)(ii)1 of this subsection, does not
indicate who performed the test; or

(ii) As provided under paragraph (1)(ii)2 of this subsection, indicates that
the test was performed by a provider or office facility but does not identify the provider or office
facility or include the amount charged by the provider or office facility.

(3)     A physician may not bill:

(i) For any amount:

1. [other] OTHER than the payment amount specified under
paragraph (1) of this subsection; [and]

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