(3) "Health care practitioner" means an individual who is licensed,
certified, or otherwise authorized under the Health Occupations Article to provide
health care services.

(b) A carrier may not reimburse 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) (1) A CARRIER SHALL PROVIDE A HEALTH CARE PRACTITIONER WITH A
WRITTEN COPY OF:

(I) THE FEE SCHEDULE THAT IS APPLICABLE TO THAT HEALTH
CARE PRACTITIONER; AND

(II) THE CODING GUIDELINES TO BE USED BY THE PRACTITIONER
WHEN SUBMITTING CLAIMS TO THE CARRIER FOR REIMBURSEMENT.

(2) A CARRIER SHALL PROVIDE THE FEE SCHEDULE AND CODING
GUIDELINES REQUIRED UNDER PARAGRAPH (1) OF THIS SUBSECTION;

(I) AT THE TIME OF CONTRACT EXECUTION OR RENEWAL; AND

(II) 90 DAYS BEFORE THE CARRIER CHANGES THE FEE SCHEDULE
OR CODING GUIDELINES.

(I) A SCHEDULE OF APPLICABLE FEES FOR UP TO THE TWENTY
MOST COMMON SERVICES BILLED BY A HEALTH CARE PRACTITIONER IN THAT
SPECIALTY; AND

(II) A DESCRIPTION OF THE CODING GUIDELINES USED BY THE
CARRIER THAT ARE APPLICABLE TO THE SERVICES BILLED BY A HEALTH CARE
PRACTITIONER IN THAT SPECIALTY.

(2) A CARRIER SHALL PROVIDE THE INFORMATION REQUIRED UNDER
PARAGRAPH (1) OF THIS SUBSECTION:

(I) AT THE TIME OF CONTRACT EXECUTION;

(II) 30 DAYS PRIOR TO A CHANGE; AND

(III) UPON REQUEST OF THE HEALTH CARE PRACTITIONER

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 COMPLIES WITH THE PROVISIONS OF § 19-705.1 of the
Health - General Article; or

(2) deter PROMOTES the delivery of medically appropriate care to an
enrollee; AND

(3) EXCEPT FOR THE PROVISION OF PREVENTIVE HEALTH CARE
SERVICES, IS NOT BASED ON THE COST, OR NUMBER OF MEDICAL SERVICES