Maryland Health Occupations 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 § 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.