{"data":{"id":"us-md/md.-code-health-occupations-1-208","jurisdiction":"us-md","citation":"Md. Code, Health Occupations § 1–208","heading":"","body":"(a) (1) In this section the following words have the meanings indicated.\n(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.\n(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.\n(iii) The exclusion provided under subparagraph (ii) of this paragraph applies only 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.\n(3) “Third party payor” means any person that administers or provides reimbursement for health care benefits on an expense incurred basis including:\n(i) A health maintenance organization issued a certificate of authority in accordance with Title 19, Subtitle 7 of the Health – General Article;\n(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\n(iii) A third party administrator registered under the Insurance Article.\n(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.\n(b) When submitting a claim or bill for reimbursement to a third party payor, a health care practitioner shall use the uniform claims form.\n(c) The uniform claims form submitted under this section:\n(1) Shall be properly completed; and\n(2) May be submitted by electronic transfer.\n(d) The Secretary may impose a penalty not to exceed $100 on any health care practitioner that violates the provisions of this section.","path":["Article - Health Occupations"],"source_url":"https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=gho\u0026section=1-208","current_through":"2026-01-01","vintage":"","retrieved_at":"2026-09-14T19:58:58Z","sha256":"59ce2dd2bbacf538918c992f0b9be7f36a4d209c26c26ee3fe837f1d30ab3a7b","source_id":"us-md","stale":false,"prev":"us-md/md.-code-health-occupations-1-207.1","next":"us-md/md.-code-health-occupations-1-209"},"notice":"GroundRules: Original legal text. Not legal advice."}