Ch. 605                                        1995 LAWS OF MARYLAND

(f) Failure to report pursuant to the requirements of this section shall result in
imposition of a civil penalty of up to $5,000 by a circuit court of this State.

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 DENTAL PLAN ORGANIZATION; OR

(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) 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.

Article - Health - General

15-102.2.

(A) (1) IN THIS SECTION, "PRACTITIONER" MEANS A PERSON LICENSED.
CERTIFIED, OR OTHERWISE AUTHORIZED UNDER THE HEALTH-OCCUPATIONS
ARTICLE TO PROVIDE HEALTH CARE SERVICES IN THE ORDINARY COURSE OF
BUSINESS OF A PROFESSION.

(2) "PRACTITIONER" INCLUDES A PHARMACY, PROFESSIONAL
SERVICES CORPORATION, PARTNERSHIP, LIMITED LIABILITY COMPANY,
PROFESSIONAL OFFICE, OR ANY OTHER ENTITY AUTHORIZED TO RENDER
PROFESSIONAL SERVICES FOR OR ON BEHALF OF A PRACTITIONER.

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