- A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
- (1) “Accredited hospital” means a hospital accredited by the Joint Commission on Accreditation of Healthcare Organizations.
- (2) “Carrier” means an insurer, a nonprofit health service plan, or a dental plan organization.
- (3) “Enrollee” means an individual entitled to health care benefits from a carrier.
- (4) “Hospital-based physician” means an anesthesiologist, pathologist, radiologist, neonatologist, hospitalist, intensivist, or emergency medicine physician that practices exclusively within an accredited hospital and provides care to enrollees only as a result of the enrollees being directed to the hospital.
- (5) “Prominent carrier” means a carrier reporting at least $90,000,000 in written premium for medical benefits in Maryland in the most recent annual statement.
- (6) “Provider” means a health care practitioner or group of health care practitioners licensed, certified, or otherwise authorized by law to provide health care services.
- (7) “Provider panel” means the providers that contract either directly or through a subcontracting entity with a carrier to provide health care services to the carrier's enrollees under the carrier's health benefit plan.
Authority: Insurance Article, §§2-108(2) and 15-112(b)(1)(i)1, Annotated Code of Maryland;
Effective date: July 17, 2008 (35:14 Md. R. 1247)