2013 Maryland Code
HEALTH - GENERAL
§ 19-1A-01 - Definitions [Subtitle subject to abrogation]


MD Health-Gen Code § 19-1A-01 (2013) What's This?

(a) In general. -- In this subtitle the following words have the meanings indicated.

(b) Carrier. -- "Carrier" has the meaning stated in § 15-1801 of the Insurance Article.

(c) Federally qualified health center. -- "Federally qualified health center" has the meaning stated in 42 U.S.C. § 254b.

(d) Health benefit plan. -- "Health benefit plan" has the meaning stated in § 15-1801 of the Insurance Article.

(e) Managed care organization. -- "Managed care organization" has the meaning stated in § 15-101 of this article.

(f) Patient centered medical home. -- "Patient centered medical home" means a primary care practice organized to provide a first, coordinated, ongoing, and comprehensive source of care to patients to:

(1) Foster a partnership with a qualifying individual;

(2) Coordinate health care services for a qualifying individual; and

(3) Exchange medical information with carriers, other providers, and qualifying individuals.

(g) Primary care practice. -- "Primary care practice" means a practice or federally qualified health center organized by or including pediatricians, general internal medicine physicians, family medicine physicians, or nurse practitioners.

(h) Prominent carrier. --

(1) "Prominent carrier" means a carrier reporting at least $ 90,000,000 in written premiums for health benefit plans in the State in the most recent Maryland health benefit plan report submitted to the Insurance Commissioner as required under § 15-605 of the Insurance Article.

(2) "Prominent carrier" does not include a group model health maintenance organization as defined in § 19-713.6 of this title.

(i) Qualifying individual. -- "Qualifying individual" means:

(1) A person covered under a health benefit plan issued by a carrier; or

(2) A member of a managed care organization.

(j) Single carrier patient centered medical home program. -- "Single carrier patient centered medical home program" has the meaning stated in § 15-1801 of the Insurance Article.

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