# Health Occupations (GHO)

## Title 1. Definitions; General Provisions

### Subtitle 3. Patient Referrals

#### Section 1-303

(a) Except as provided in subsection (c) of this section and Title 12 of this article, a health care practitioner making a lawful referral shall disclose the existence of the beneficial interest in accordance with provisions of this section.

(b) Prior to referring a patient to a health care entity in which the practitioner, the practitioner's immediate family, or the practitioner in combination with the practitioner's immediate family owns a beneficial interest, the health care practitioner shall:

  (1) Except if an oral referral is made by telephone, provide the patient with a written statement that:

    (i) Discloses the existence of the ownership of the beneficial interest or compensation arrangement;

    (ii) States that the patient may choose to obtain the health care service from another health care entity; and

    (iii) Requires the patient to acknowledge in writing receipt of the statement;

  (2) Except if an oral referral is made by telephone, insert in the medical record of the patient a copy of the written acknowledgement;

  (3) Place on permanent display a written notice that is in a typeface that is large enough to be easily legible to the average person from a distance of 8 feet and that is in a location that is plainly visible to the patients of the health care practitioner disclosing all of the health care entities:

    (i) In which the practitioner, the practitioner's immediate family, or the practitioner in combination with the practitioner's immediate family owns a beneficial interest; and

    (ii) To which the practitioner refers patients; and

  (4) Documents in the medical record of the patient that:

    (i) A valid medical need exists for the referral; and

    (ii) The practitioner has disclosed the existence of the beneficial interest to the patient.

(c) The provisions of this section do not apply to:

  (1) A health care practitioner when treating a member of a health maintenance organization as defined in Sec. 19-701 of the Health - General Article and the health care practitioner does not have a beneficial interest in the health care entity; or

  (2) A health care practitioner who refers a patient:

    (i) To another health care practitioner in the same group practice as the referring health care practitioner;

    (ii) For in-office ancillary services; or

    (iii) For health care services provided through or by a health care entity owned or controlled by a hospital.

(d) A health care practitioner who fails to comply with any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000.

---

Md. Code Ann., Health Occ. (as displayed at mgaleg.maryland.gov, October 16, 2026)