PARRIS N. GLENDENING, Governor

Ch. 35

In subsection (f)(2) of this section, the reference to "§§ 15-1004 and 15-1005
of this title" is substituted for the former references to Art. 48A, §§ "354Z",
"470U", and "477AA". The substituted reference is more specific than the
former general reference. No substantive change is intended.

In subsection (g) of this section, the reference to a claim, bill, or "other
demand or" request for payment is added for consistency within this section.

Also in subsection (g) of this section, the reference to a claim, bill, or other
demand or request for payment determined to be "for a health care service
provided as" a result of a prohibited referral is added for clarity.

Defined terms: "Commissioner" § 1-101
"Health insurance" § 1-101
"Insurer" § 1-101
"Policy" § 1-101

15-111. ASSESSMENT OF FEES ON PAYORS.

(A) DEFINITIONS.

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

(2) "HEALTH BENEFIT PLAN" HAS THE MEANING STATED IN § 15-1201 OF
THIS TITLE.

(3) "PAYOR" MEANS:

(I) A HEALTH INSURER OR NONPROFIT HEALTH SERVICE PLAN
THAT HOLDS A CERTIFICATE OF AUTHORITY AND PROVIDES HEALTH INSURANCE
POLICIES OR CONTRACTS IN THE STATE UNDER THIS ARTICLE;

(II) A HEALTH MAINTENANCE ORGANIZATION THAT IS
AUTHORIZED BY THE COMMISSIONER TO OPERATE IN THE STATE; OR

(III) A THIRD PARTY ADMINISTRATOR.

(4) "THIRD PARTY ADMINISTRATOR" MEANS A PERSON THAT IS
REGISTERED AS AN ADMINISTRATOR UNDER THIS ARTICLE.

(B) IN GENERAL.

(1) ON OR BEFORE JUNE 30 OF EACH YEAR, THE COMMISSIONER SHALL
ASSESS EACH PAYOR A FEE FOR THE NEXT FISCAL YEAR.

(2) THE FEE SHALL BE ESTABLISHED IN ACCORDANCE WITH THIS
SECTION AND § 19-1515 OF THE HEALTH - GENERAL ARTICLE.

(C) AMOUNT OF ASSESSMENT.

(1) FOR EACH FISCAL YEAR, THE TOTAL ASSESSMENT FOR ALL PAYORS

SHALL BE:

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