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<section article="ghg" article_name="Health - General" number="19-132" title_number="19" title_name="Health Care Facilities" subtitle_number="1" subtitle_name="Health Care Planning and Systems Regulation">
  <level label="a">
    <text>In this Part III of this subtitle the following words have the meanings indicated.</text>
  </level>
  <level label="b">
    <text>“Ambulatory surgical facility” has the meaning stated in § 19–3B–01 of this title.</text>
  </level>
  <level label="c">
    <text>“Carrier” means:</text>
    <level label="1">
      <text>An insurer or nonprofit health service plan that holds a certificate of authority and provides health insurance policies or contracts in the State in accordance with the Insurance Article; or</text>
    </level>
    <level label="2">
      <text>A health maintenance organization that holds a certificate of authority in the State.</text>
    </level>
  </level>
  <level label="d">
    <text>“Comprehensive standard health benefit plan” means the comprehensive standard health benefit plan adopted in accordance with § 15–1207 of the Insurance Article.</text>
  </level>
  <level label="e">
    <level label="1">
      <text>“Health benefit plan” means a hospital or medical policy, contract, or certificate issued by a carrier.</text>
    </level>
    <level label="2">
      <text>“Health benefit plan” does not include:</text>
      <level label="i">
        <text>Coverage for accident or disability income insurance;</text>
      </level>
      <level label="ii">
        <text>Coverage issued as a supplement to liability insurance;</text>
      </level>
      <level label="iii">
        <text>Liability insurance, including general liability insurance and automobile liability insurance;</text>
      </level>
      <level label="iv">
        <text>Workers’ compensation or similar insurance;</text>
      </level>
      <level label="v">
        <text>Automobile or property medical payment insurance;</text>
      </level>
      <level label="vi">
        <text>Credit–only insurance;</text>
      </level>
      <level label="vii">
        <text>Coverage for on–site medical clinics;</text>
      </level>
      <level label="viii">
        <text>Dental or vision insurance;</text>
      </level>
      <level label="ix">
        <text>Long–term care insurance or benefits for nursing home care, home health care, community–based care, or any combination of these;</text>
      </level>
      <level label="x">
        <text>Coverage only for a specified disease or illness;</text>
      </level>
      <level label="xi">
        <text>Hospital indemnity or other fixed indemnity insurance; or</text>
      </level>
      <level label="xii">
        <text>The following benefits if offered as a separate insurance policy:</text>
        <level label="1">
          <text>Medicare supplemental health insurance, as defined in § 1882(g)(1) of the Social Security Act;</text>
        </level>
        <level label="2">
          <text>Coverage supplemental to the coverage provided under Chapter 55 of Title 10 of the United States Code; or</text>
        </level>
        <level label="3">
          <text>Similar supplemental coverage provided to coverage under an employer sponsored plan.</text>
        </level>
      </level>
    </level>
  </level>
  <level label="f">
    <text>“Health care practitioner” means any individual who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care services.</text>
  </level>
  <level label="g">
    <level label="1">
      <text>“Health care provider” means:</text>
      <level label="i">
        <text>A person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care in the ordinary course of business or practice of a profession or in an approved education or training program; or</text>
      </level>
      <level label="ii">
        <text>A facility where health care is provided to patients or recipients, including:</text>
        <level label="1">
          <text>A facility, as defined in § 10–101(g) of this article;</text>
        </level>
        <level label="2">
          <text>A hospital, as defined in § 19–301 of this title;</text>
        </level>
        <level label="3">
          <text>A related institution, as defined in § 19–301 of this title;</text>
        </level>
        <level label="4">
          <text>A health maintenance organization, as defined in § 19–701(g) of this title;</text>
        </level>
        <level label="5">
          <text>An outpatient clinic; and</text>
        </level>
        <level label="6">
          <text>A medical laboratory.</text>
        </level>
      </level>
    </level>
    <level label="2">
      <text>“Health care provider” includes the agents and employees of a facility who are licensed or otherwise authorized to provide health care, the officers and directors of a facility, and the agents and employees of a health care provider who are licensed or otherwise authorized to provide health care.</text>
    </level>
  </level>
  <level label="h">
    <text>“Health care service” means any health or medical care procedure or service rendered by a health care practitioner that:</text>
    <level label="1">
      <text>Provides testing, diagnosis, or treatment of human disease or dysfunction; or</text>
    </level>
    <level label="2">
      <text>Dispenses drugs, medical devices, medical appliances, or medical goods for the treatment of human disease or dysfunction.</text>
    </level>
  </level>
  <level label="i">
    <text>“Hospital” has the meaning stated in § 19–301 of this title.</text>
  </level>
  <level label="j">
    <level label="1">
      <text>“Mandated health insurance service” means a legislative proposal or statute that would require a particular health care service to be provided or offered in a health benefit plan, by a carrier or other organization authorized to provide health benefit plans in the State.</text>
    </level>
    <level label="2">
      <text>“Mandated health insurance service”, as applicable to all carriers, does not include services enumerated to describe a health maintenance organization under § 19–701(g)(2) of this title.</text>
    </level>
  </level>
  <level label="k">
    <text>“Nursing facility” has the meaning stated in § 19–1401 of this title.</text>
  </level>
  <level label="l">
    <level label="1">
      <text>“Office facility” means the office of one or more health care practitioners in which health care services are provided to individuals.</text>
    </level>
    <level label="2">
      <text>“Office facility” includes a facility that provides:</text>
      <level label="i">
        <text>Ambulatory surgery;</text>
      </level>
      <level label="ii">
        <text>Radiological or diagnostic imagery; or</text>
      </level>
      <level label="iii">
        <text>Laboratory services.</text>
      </level>
    </level>
    <level label="3">
      <text>“Office facility” does not include any office, facility, or service operated by a hospital and regulated under Part II of this subtitle.</text>
    </level>
  </level>
  <level label="m">
    <text>“Payor” means:</text>
    <level label="1">
      <text>A health insurer or nonprofit health service plan that holds a certificate of authority and provides health insurance policies or contracts in the State in accordance with this article or the Insurance Article;</text>
    </level>
    <level label="2">
      <text>A health maintenance organization that holds a certificate of authority in the State; or</text>
    </level>
    <level label="3">
      <text>For the purposes of this Part III of this subtitle only, a person that is registered as an administrator under Title 8, Subtitle 3 of the Insurance Article.</text>
    </level>
  </level>
</section>
