§ 1–208
Statutes in effect as of October 1, 2026.
Md. Code Ann., Health Occ. § 1-208 (2026)
Title 1. Definitions; General Provisions
Subtitle 2. General Provisions
§ 1–208LinkCopy Citation
(a)
(1)
In this section the following words have the meanings indicated.
(2)
(i)
Except as otherwise provided in this paragraph, “health care practitioner” means a physician or any other person licensed or certified under this article and reimbursed by a third party payor.
(ii)
Subject to the provisions of subparagraph (iii) of this paragraph, “health care practitioner” does not include a physician or other person licensed or certified under this article who is compensated by a health maintenance organization on a salaried or capitated basis.
(iii)
The exclusion provided under subparagraph (ii) of this paragraph applies only when the physician or other licensed or certified person is rendering care to a member or subscriber of the health maintenance organization on a salaried or capitated system basis.
(3)
“Third party payor” means any person that administers or provides reimbursement for health care benefits on an expense incurred basis including:
(i)
A health maintenance organization issued a certificate of authority in accordance with Title 19, Subtitle 7 of the Health – General Article;
(ii)
A health insurer or nonprofit health service plan authorized to offer health insurance policies or contracts in this State in accordance with the Insurance Article; or
(iii)
A third party administrator registered under the Insurance Article.
(4)
“Uniform claims form” means the claim or billing form for reimbursement of services rendered by a health care practitioner adopted by the Insurance Commissioner under § 15–1003 of the Insurance Article.
(b)
When submitting a claim or bill for reimbursement to a third party payor, a health care practitioner shall use the uniform claims form.
(c)
The uniform claims form submitted under this section:
(1)
Shall be properly completed; and
(2)
May be submitted by electronic transfer.
(d)
The Secretary may impose a penalty not to exceed $100 on any health care practitioner that violates the provisions of this section.