<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".02" citation="COMAR 31.10.16.02" title_num="31" subtitle_num="10" chapter_num="16" heading="Definitions.">
  <paragraph num="A.">
    <text>In this chapter, the following terms have the meanings indicated.</text>
  </paragraph>
  <paragraph num="B.">
    <text>Terms Defined.</text>
    <paragraph num="(1)">
      <text>Carrier.</text>
      <paragraph num="(a)">
        <text>“Carrier” means:</text>
        <paragraph num="(i)">
          <text>An insurer;</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>A nonprofit health service plan;</text>
        </paragraph>
        <paragraph num="(iii)">
          <text>A health maintenance organization;</text>
        </paragraph>
        <paragraph num="(iv)">
          <text>A dental plan organization; and</text>
        </paragraph>
        <paragraph num="(v)">
          <text>Any other person or organization that provides health benefit plans subject to State regulation.</text>
        </paragraph>
      </paragraph>
      <paragraph num="(b)">
        <text>“Carrier” includes an entity that arranges a provider panel for a carrier.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>“Provider” means a health care practitioner or a group of health care practitioners licensed or otherwise authorized by law to provide health care services.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Provider Panel.</text>
      <paragraph num="(a)">
        <text>“Provider panel” means those providers with which a carrier contracts to provide health care services to the carrier's enrollees under the carrier's health benefit plan.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Provider panel” does not include an arrangement between a carrier and providers in which a provider may participate solely on the basis of the provider's contracting with the carrier to provide services at a discounted fee-for-service rate.</text>
      </paragraph>
    </paragraph>
  </paragraph>
</regulation>