1. (a) In this part the following words have the meanings indicated.

2. (b) “False representation” means the knowing and willful:

   1. (1) concealing, falsifying, or omitting of a material fact;
   2. (2) making of a materially false or fraudulent statement; or
   3. (3) use of a document that contains a statement of material fact that the user knows to be false or fraudulent.

3. (c)

   1. (1) “Health care service” means health or medical care procedures, goods, or services that:

      1. (i) provide testing, diagnosis, or treatment of human disease or dysfunction; or
      2. (ii) dispense drugs, medical devices, medical appliances, or medical goods for the treatment of human disease or dysfunction.
   2. (2) “Health care service” includes any procedure, goods, or service that is a required benefit of a State health plan.
4. (d) “Representation” includes an acknowledgment, certification, claim, ratification, report of demographic statistics, encounter data, enrollment claims, financial information, health care services available or rendered, and qualifications of a person rendering health care or ancillary services.

5. (e) “Serious injury” means an injury that:

   1. (1) creates a substantial risk of death;
   2. (2) causes serious permanent or serious protracted disfigurement;
   3. (3) causes serious permanent or serious protracted loss of the function of any body part, organ, or mental faculty;
   4. (4) causes serious permanent or serious protracted impairment of the function of any bodily member or organ; or
   5. (5) involves extreme physical pain.

6. (f)

   1. (1) “State health plan” includes:

      1. (i) the State Medical Assistance Plan established in accordance with Title XIX of the federal Social Security Act of 1939;¹
      2. (ii) a medical assistance plan established by the State; or
      3. (iii) a private health insurance carrier, health maintenance organization, managed care organization as defined in § 15-101 of the Health--General Article, health care cooperative or alliance, or other person that provides or contracts to provide health care services that are wholly or partly reimbursed by or are a required benefit of a health plan established in accordance with Title XIX of the federal Social Security Act of 1939 or by the State.
   2. (2) “State health plan” includes a person that provides or contracts or subcontracts to provide health care services for an entity described in paragraph (1) of this subsection.

Added by Acts 2002, c. 26, § 2, eff. Oct. 1, 2002.

Formerly Art. 27, § 230B.

Aug. 14, 1935, ch. 531, 49 Stat. 620, codified at 42 U.S.C.A. § 301 et seq.