Maryland Health Occupations Section 1-208

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

            (2)      (i)      Except as otherwise provided in this paragraph, "health care practitioner" means a physician or any other person licensed or certified under this article and reimbursed by a third party payor.

                  (ii)      Subject to the provisions of subparagraph (iii) of this paragraph, "health care practitioner" does not include a physician or other person licensed or certified under this article who is compensated by a health maintenance organization on a salaried or capitated basis.

                  (iii)      The exclusion provided under subparagraph (ii) of this paragraph only applies when the physician or other licensed or certified person is rendering care to a member or subscriber of the health maintenance organization on a salaried or capitated system basis.

            (3)      "Third party payor" means any person that administers or provides reimbursement for health care benefits on an expense incurred basis including:

                  (i)      A health maintenance organization issued a certificate of authority in accordance with Title 19, Subtitle 7 of the Health - General Article;

                  (ii)      A health insurer or nonprofit health service plan authorized to offer health insurance policies or contracts in this State in accordance with the Insurance Article; or

                  (iii)      A third party administrator registered under the Insurance Article.

            (4)      "Uniform claims form" means the claim or billing form for reimbursement of services rendered by a health care practitioner adopted by the Insurance Commissioner under § 15-1003 of the Insurance Article.

      (b)      When submitting a claim or bill for reimbursement to a third party payor, a health care practitioner shall use the uniform claims form.

      (c)      The uniform claims form submitted under this section:

            (1)      Shall be properly completed; and

            (2)      May be submitted by electronic transfer.

      (d)      The Secretary may impose a penalty not to exceed $100 on any health care practitioner that violates the provisions of this section.