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Ch. 26
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PARRIS N. GLENDENING, Governor
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REVISOR'S NOTE: This subsection formerly was Art. 27, § 230B(e).
No changes are made.
(F) STATE HEALTH PLAN.
(1) "STATE HEALTH PLAN" INCLUDES:
(I) THE STATE MEDICAL ASSISTANCE PLAN ESTABLISHED IN
ACCORDANCE WITH TITLE XIX OF THE FEDERAL SOCIAL SECURITY ACT OF 1939;
(II) A MEDICAL ASSISTANCE PLAN ESTABLISHED BY THE STATE; OR
(III) A PRIVATE HEALTH INSURANCE CARRIER, HEALTH
MAINTENANCE ORGANIZATION, MANAGED CARE ORGANIZATION AS DEFINED IN §
15-101 OF THE HEALTH - GENERAL ARTICLE, HEALTH CARE COOPERATIVE OR
ALLIANCE, OR OTHER PERSON THAT PROVIDES OR CONTRACTS TO PROVIDE HEALTH
CARE SERVICES THAT ARE WHOLLY OR PARTLY REIMBURSED BY OR ARE A
REQUIRED BENEFIT OF A HEALTH PLAN ESTABLISHED IN ACCORDANCE WITH TITLE
XIX OF THE FEDERAL SOCIAL SECURITY ACT OF 1939 OR BY THE STATE.
(2) "STATE HEALTH PLAN" INCLUDES A PERSON THAT PROVIDES OR
CONTRACTS OR SUBCONTRACTS TO PROVIDE HEALTH CARE SERVICES FOR AN
ENTITY DESCRIBED IN PARAGRAPH (1) OF THIS SUBSECTION.
REVISOR'S NOTE: This subsection formerly was Art. 27, § 230B(f).
No changes are made.
Defined term: "Person" § 1-101
8-509. PROHIBITED — DEFRAUDING STATE HEALTH PLAN.
A PERSON MAY NOT:
(1) KNOWINGLY AND WILLFULLY DEFRAUD OR ATTEMPT TO DEFRAUD A
STATE HEALTH PLAN IN CONNECTION WITH THE DELIVERY OF OR PAYMENT FOR A
HEALTH CARE SERVICE;
(2) KNOWINGLY AND WILLFULLY OBTAIN OR ATTEMPT TO OBTAIN BY
MEANS OF A FALSE REPRESENTATION MONEY, PROPERTY, OR ANY THING OF VALUE
IN CONNECTION WITH THE DELIVERY OF OR PAYMENT FOR A HEALTH CARE SERVICE
THAT WHOLLY OR PARTLY IS REIMBURSED BY OR IS A REQUIRED BENEFIT OF A
STATE HEALTH PLAN;
(3) KNOWINGLY AND WILLFULLY DEFRAUD OR ATTEMPT TO DEFRAUD A
STATE HEALTH PLAN OF THE RIGHT TO HONEST SERVICES; OR
(4) WITH THE INTENT TO DEFRAUD MAKE A FALSE REPRESENTATION
RELATING TO A HEALTH CARE SERVICE OR A STATE HEALTH PLAN.
REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 27, § 230C.
Defined terms: "False representation" § 8-508
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- 621 -
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