Ch. 440                                    2003 LAWS OF MARYLAND

Section 19-710.1(b)

Annotated Code of Maryland

(2000 Replacement Volume and 2002 Supplement)

(As enacted by Chapter 275 of the Acts of the General Assembly of 2000)

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF
MARYLAND, That Section(s) 19-701(d) through (i), respectively, of Article - Health -
General of the Annotated Code of Maryland be renumbered to be Section(s) 19-701(e)
through (j), respectively.

SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland
read as follows:

Article - Health - General

19-701.

(a) In this subtitle the following words have the meanings indicated.

(D) "COVERED SERVICE" MEANS A HEALTH-CARE SERVICE INCLUDED IN THE
BENEFIT PACKAGE OF THE HEALTH MAINTENANCE ORGANIZATION AND RENDERED
TO AN ENROLLEE OF THE HEALTH MAINTENANCE ORGANIZATION BY A HEALTH
CARE PROVIDER, INCLUDING A PHYSICIAN OR HOSPITAL;

(1) PURSUANT TO A VERBAL OR WRITTEN REFERRAL BY THE
ENROLLEE'S HEALTH MAINTENANCE ORGANIZATION OR BY A PROVIDER UNDER

WRITTEN CONTRACT WITH THE ENROLLEE'S HEALTH MAINTENANCE

ORGANIZATION; OR

(2) THAT HAS BEEN PREAUTHORIZED OR OTHERWISE APPROVED
EITHER VERBALLY OR IN WRITING BY THE ENROLLEE'S HEALTH MAINTENANCE
ORGANIZATION OR A PROVIDER UNDER WRITTEN CONTRACT WITH THE ENROLLEE'S
HEALTH MAINTENANCE ORGANIZATION.

(D) "COVERED SERVICE" MEANS A HEALTH CARE SERVICE INCLUDED IN THE
BENEFIT PACKAGE OF THE HEALTH MAINTENANCE ORGANIZATION AND RENDERED
TO A MEMBER OR SUBSCRIBER OF THE HEALTH MAINTENANCE ORGANIZATION BY:

(1)  A PROVIDER UNDER CONTRACT WITH THE HEALTH MAINTENANCE
ORGANIZATION, WHEN THE SERVICE IS OBTAINED IN ACCORDANCE WITH THE
TERMS OF THE BENEFIT CONTRACT OF THE MEMBER OR SUBSCRIBER; OR

(2)  A NONCONTRACTING PROVIDER UNDER § 19-710.1 OF THIS SUBTITLE,
WHEN THE SERVICE IS:

(I)  OBTAINED IN ACCORDANCE WITH THE TERMS OF THE BENEFIT
CONTRACT OF THE MEMBER OR SUBSCRIBER;

(II)  OBTAINED PURSUANT TO A VERBAL OR WRITTEN REFERRAL
BY:

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