PARRIS N. GLENDENING, Governor

Ch. 35

ENTITLED TO RECEIVE HEALTH CARE SERVICES FROM PREFERRED PROVIDERS AT
NO COST, AT A REDUCED FEE, OR UNDER MORE FAVORABLE TERMS THAN IF THE
INSURED OR SUBSCRIBER RECEIVED SIMILAR SERVICES FROM A NONPREFERRED
PROVIDER.

REVISOR'S NOTE: This subsection is new language derived without substantive
change from former Art. 48A, § 655(e).

The reference to "an arrangement under which" the insured or subscriber is
entitled to receive health care services is added for clarity.

Defined terms: "Insured" § 14-201

"Nonpreferred provider" § 14-201
"Preferred provider" § 14-201
"Preferred provider insurance policy" § 14-201
"Subscriber" § 14-201

(E) PREFERRED PROVIDER.

"PREFERRED PROVIDER" MEANS A PROVIDER THAT HAS ENTERED INTO A
PROVIDER SERVICE CONTRACT.

REVISOR'S NOTE: This subsection is new language derived without substantive
change from former Art. 48A, § 655(f).

The former references to the other parties to a provider service contract are
deleted as unnecessary in light of the use of the defined term "provider service
contract".

Defined terms: "Provider" § 14-201

"Provider service contract" § 14-201

(F) PREFERRED PROVIDER INSURANCE POLICY.
"PREFERRED PROVIDER INSURANCE POLICY" MEANS:

(1) A POLICY OR INSURANCE CONTRACT THAT IS ISSUED OR
DELIVERED IN THE STATE BY AN INSURER, UNDER WHICH HEALTH CARE SERVICES
ARE TO BE PROVIDED TO THE INSURED BY A PREFERRED PROVIDER ON A
PREFERENTIAL BASIS; OR

(2) ANOTHER CONTRACT THAT IS OFFERED BY AN EMPLOYER, THIRD
PARTY ADMINISTRATOR, OR OTHER ENTITY, UNDER WHICH HEALTH CARE
SERVICES ARE TO BE PROVIDED TO THE SUBSCRIBER BY A PREFERRED PROVIDER
ON A PREFERENTIAL BASIS.

REVISOR'S NOTE: This subsection is new language derived without substantive
change from former Art. 48A, § 655(g).

In items (1) and (2) of this subsection, the references to health "care" services
are added for clarity and consistency with subsections (d), (g), and (h) of this
section and § 14-204(1) of this subtitle.

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