PARRIS N. GLENDENING, Governor

Ch. 548

(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] A 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.
490FF.

(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 PROVIDER" MEANS?

(I) ANY INDIVIDUAL WHO IS LICENSED, CERTIFIED, OR
OTHERWISE AUTHORIZED UNDER THE HEALTH OCCUPATIONS ARTICLE TO
PROVIDE HEALTH CARE SERVICES; OR

(II) A HOSPITAL LICENSED UNDER TITLE 10 OF THE HEALTH—
GENERAL ARTICLE.

(B)     A CARRIER, AS A CONDITION OF A CONTRACT WITH A HEALTH CARE
PROVIDER, OR IN ANY OTHER MANNER, MAY NOT PROHIBIT A HEALTH CARE
PROVIDER FROM DISCUSSING OR COMMUNICATING TO AN ENROLLEE, PUBLIC
OFFICIAL, SUBSCRIBER, OR OTHER PERSON INFORMATION THAT IS NECESSARY OR
APPROPRIATE FOR THE DELIVERY OF HEALTH CARE SERVICES, INCLUDING

(1)     COMMUNICATIONS RELATING TO TREATMENT ALTERNATIVES;

(2)     COMMUNICATIONS NECESSARY OR APPROPRIATE TO MAINTAIN
THE PROVIDER-PATIENT RELATIONSHIP WHILE THE PATIENT IS UNDER THE
PROVIDER'S CARE;

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