Ch. 415                                    2004 LAWS OF MARYLAND

(i) is licensed or otherwise authorized to provide health care
services in the ordinary course of business or practice of a profession; and

(ii) is a treating provider of a patient; or

(2)     a hospital, as defined in § 19-301 of the Health—General Article.

[(i)](J) "Health care service" means a health or medical care procedure or
service rendered by a health care provider licensed or authorized to provide health
care services that:

(1)     provides testing, diagnosis, or treatment of a human disease or
dysfunction;

(2) dispenses drugs, medical devices, medical appliances, or medical
goods for the treatment of a human disease or dysfunction; or

(3) provides any other care, service, or treatment of disease or injury, the
correction of defects, or the maintenance of the physical and mental well being of
human beings.

[(j)] (K) "Health care service reviewer" means an individual who is licensed or
otherwise authorized to provide health care services in the ordinary course of
business or practice of a profession.

[(k)] (L) "Private review agent" means:

(1) a nonhospital affiliated person or entity performing utilization
review that is either affiliated with, under contract with, or acting on behalf of:

(i) a Maryland business entity; or

(ii) a third party that pays for, provides, or administers health care
services to citizens of this State; or

(2) any person or entity including a hospital affiliated person
performing utilization review for the purpose of making claims or payment decisions
for health care services on behalf of the employer's or labor union's health insurance
plan under an employee assistance program for employees other than the employees
employed by:

(i) the hospital; or

(ii) a business wholly owned by the hospital.

[(l)](M) "Significant beneficial interest" means the ownership of any financial
interest that is greater than the lesser of:

(1) 5 percent of the whole; or

(2) $5,000.

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