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<regulation prefix="Regulation" num=".02" citation="COMAR 31.10.22.02" title_num="31" subtitle_num="10" chapter_num="22" 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>“Commissioner” means the Maryland Insurance Commissioner.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Contract” means the contractual agreement for the provision of health care services on a prepaid, capitated basis entered into between a provider-sponsored organization and the Health Care Finance Administration to provide health care benefits to medicare program beneficiaries.</text>
    </paragraph>
    <paragraph num="(3)">
      <text>“Enrollee” means an individual who is enrolled in a provider-sponsored organization.</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Health Care Delivery Assets.</text>
      <paragraph num="(a)">
        <text>“Health care delivery assets” means any tangible asset that is part of a provider-sponsored organization operation.</text>
      </paragraph>
      <paragraph num="(b)">
        <text>“Health care delivery assets” includes:</text>
        <paragraph num="(i)">
          <text>Hospitals, medical facilities, and their ancillary equipment; and</text>
        </paragraph>
        <paragraph num="(ii)">
          <text>Property as may reasonably be required for a provider-sponsored organization's principal office or for such purposes as may be necessary in the transaction of the business of a provider-sponsored organization.</text>
        </paragraph>
      </paragraph>
    </paragraph>
    <paragraph num="(5)">
      <text>“Health Care Finance Administration” means the Health Care Finance Administration of the federal Department of Health and Human Services.</text>
    </paragraph>
    <paragraph num="(6)">
      <text>“Health care services” means a health or medical procedure or service rendered by a health care provider that:</text>
      <paragraph num="(a)">
        <text>Provides testing, diagnosis, or treatment of a human disease or dysfunction; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Dispenses drugs, medical devices, medical appliances, or medical goods for the treatment of a human disease or dysfunction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(7)">
      <text>“Insolvent” means the condition of having been:</text>
      <paragraph num="(a)">
        <text>Declared as not meeting the fiscal requirements for continued licensing; or</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Placed under an order of liquidation by a court of competent jurisdiction.</text>
      </paragraph>
    </paragraph>
    <paragraph num="(8)">
      <text>“Leasehold estate improvements” means improvements made to property that is leased by a provider-sponsored organization and used by it to provide health care services directly.</text>
    </paragraph>
    <paragraph num="(9)">
      <text>“Net worth” means the excess of total admitted assets over liabilities, but the liabilities may not include fully subordinated debt.</text>
    </paragraph>
    <paragraph num="(10)">
      <text>“Provider” means a physician, hospital, or other person licensed or otherwise authorized to provide health care services.</text>
    </paragraph>
    <paragraph num="(11)">
      <text>“Provider-sponsored organization” has the meaning stated in Health-General Article, §19-7A-01(f), Annotated Code of Maryland.</text>
    </paragraph>
    <paragraph num="(12)">
      <text>“Subordinated debt” means a surplus account item derived from the subordination of provider-sponsored organization debts to owners, medical providers, or other creditors.</text>
    </paragraph>
  </paragraph>
</regulation>