PARRIS N. GLENDENING, Governor                                 Ch. 604

490CC.

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

(2) "CARRIER" MEANS:

(I) AN INSURER;

(II)     A NONPROFIT HEALTH SERVICE PLAN;

(III)    A HEALTH MAINTENANCE ORGANIZATION;

(IV) A PREFERRED PROVIDER ORGANIZATION; OR

(V) (IV) A DENTAL PLAN ORGANIZATION; OR

(V) (VI) (V) ANY OTHER PERSON OR ORGANIZATION THAT
PROVIDES HEALTH BENEFIT PLANS SUBJECT TO STATE REGULATION.

(3) "HEALTH CARE PRACTITIONER" MEANS ANY INDIVIDUAL WHO IS
LICENSED, CERTIFIED, OR OTHERWISE AUTHORIZED UNDER THE HEALTH
OCCUPATIONS ARTICLE TO PROVIDE HEALTH CARE SERVICES.

(B) A CARRIER THAT REIMBURSES A HEALTH CARE PRACTITIONER ON AN
AGGREGATE FIXED SUM BASIS OR ON A PER CAPITA BASIS MAY NOT REIMBURSE
THE HEALTH CARE PRACTITIONER IN AN AMOUNT LESS THAN THE SUM OR RATE
NEGOTIATED IN THE CARRIER'S PROVIDER CONTRACT WITH THE HEALTH CARE
PRACTITIONER.

(C) A CARRIER MAY NOT WITHHOLD FROM OR IN ANY MANNER DENY THE
HEALTH CARE PRACTITIONER THE CONTRACTED AGGREGATE FIXED SUM OR PER
CAPITA RATE.

(D) (C) THIS SECTION DOES NOT PROHIBIT A CARRIER FROM PROVIDING
BONUSES OR OTHER INCENTIVE-BASED COMPENSATION TO A HEALTH CARE
PRACTITIONER IF THE BONUS OR OTHER INCENTIVE-BASED COMPENSATION DOES
NOT:

(1) VIOLATE THE PROVISIONS OF § 19-705.1 OF THE HEALTH - GENERAL
ARTICLE; OR

(2) DETER THE DELIVERY OF MEDICALLY APPROPRIATE CARE TO AN
ENROLLEE.

SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read as
follows:

Article 48A - Insurance Code

490DD.

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

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