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Martin O'Malley, Governor
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S.B. 596
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(E) "DISCOUNT MEDICAL PLAN ORGANIZATION" MEANS AN ENTITY
THAT:
(1) CONTRACTS DIRECTLY OR INDIRECTLY WITH PROVIDERS OR
PROVIDER NETWORKS TO PROVIDE MEDICAL SERVICES AT A DISCOUNT TO PLAN
MEMBERS; AND
(2) DETERMINES THE CHARGE TO PLAN MEMBERS.
(F) "HOSPITAL SERVICES" HAS THE MEANING STATED IN § 19-201 OF
THE HEALTH - GENERAL ARTICLE.
(G) "MEDICAL SERVICES" MEANS ANY CARE, SERVICE, OR TREATMENT
OF ILLNESS OR DYSFUNCTION OF, OR INJURY TO, THE HUMAN BODY, INCLUDING
PHYSICIAN CARE, OUTPATIENT SERVICES, AMBULANCE SERVICES, DENTAL
CARE SERVICES, VISION CARE SERVICES, MENTAL HEALTH SERVICES,
SUBSTANCE ABUSE SERVICES, CHIROPRACTIC SERVICES, PODIATRIC CARE
SERVICES, AND LABORATORY SERVICES.
(H) "MEDICARE PRESCRIPTION DRUG PLAN" MEANS A PLAN THAT
PROVIDES A MEDICARE PART D PRESCRIPTION DRUG BENEFIT IN
ACCORDANCE WITH THE REQUIREMENTS OF THE FEDERAL MEDICARE
MODERNIZATION ACT.
(I) "PLAN MEMBER" MEANS ANY INDIVIDUAL WHO PAYS FEES, DUES,
CHARGES, OR OTHER FINANCIAL CONSIDERATION FOR THE RIGHT TO RECEIVE
THE BENEFITS OF A DISCOUNT MEDICAL PLAN OR A DISCOUNT DRUG PLAN.
(J) "PROVIDER" MEANS:
(1) ANY PERSON OR INSTITUTION WHICH IS CONTRACTED,
DIRECTLY OR INDIRECTLY, WITH A DISCOUNT MEDICAL PLAN ORGANIZATION TO
PROVIDE MEDICAL SERVICES TO PLAN MEMBERS; OR
(2) ANY PERSON OR INSTITUTION WHICH IS CONTRACTED,
DIRECTLY OR INDIRECTLY, WITH A DISCOUNT DRUG PLAN ORGANIZATION TO
PROVIDE PHARMACEUTICAL SUPPLIES, PRESCRIPTION DRUGS, OR MEDICAL
EQUIPMENT AND SUPPLIES TO PLAN MEMBERS.
(K) "STATE PRESCRIPTION DRUG PLAN" MEANS ANY DISCOUNT PLAN
OPERATED BY A STATE AGENCY.
14-602.
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