Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 1
Subtitle 01 - PROCEDURES
Chapter 10.01.15 - Exemption from Self-Referral Laws
Section 10.01.15.02 - Definitions-Applicable to Health Occupations Article, Section1-301 et seq., Annotated Code of Maryland
Universal Citation: MD Code Reg 10.01.15.02
Current through Register Vol. 51, No. 19, September 20, 2024
A. For the purpose of enforcing Health Occupations Article, §1-301 et seq., Annotated Code of Maryland, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Group practice" means a group of two or
more health care practitioners legally organized as a partnership, professional
corporation, limited liability company, foundation, not-for-profit corporation,
faculty practice plan, or similar association:
(a) In which each health care practitioner
who is a member of the group as defined in this chapter provides substantially
the full range of services which the practitioner routinely provides through
the joint use of shared office space, facilities, equipment, and
personnel;
(b) For which
substantially all, that is, at least 75 percent, of the patient care services
of all of the health care practitioners who are members of the group are
provided through the group and are billed under a billing number assigned to
the group and amounts so received are treated as receipts of the group;
and
(c) In which the overhead
expenses of and the income from the practice are distributed in accordance with
methods previously determined on an annual basis by members of the
group.
(2) "Health care
service" means medical procedures, tests, and services provided to a patient by
or through a health care entity, including supplies, drugs, and items furnished
to a patient by a health care entity.
(3) "Members of the group" means health care
practitioners:
(a) With an ownership interest
in the group practice; or
(b) Who
are full-time or part-time contractors or employees during the time they
furnish services to patients of the group practice that are furnished through
the group and are billed in the name of the group.
(4) "Patient care services" means the total
patient care time spent on any task performed by a group practice member that
addresses the medical needs of specific patients, regardless of whether they
involve direct patient encounters, and including but not limited to time spent:
(a) By a member of the group in consultation
with other health care practitioners, whether or not they are members of the
group; and
(b) Reviewing laboratory
tests, as well as the services of other health care practitioners who do not
directly treat patients.
(5) "Personally supervised" means the
responsibility of a health care practitioner to exercise on-site supervision or
immediately available direction for employees performing referred in-office
ancillary services or tests.
(6)
"Referring health care practitioner" means a health care practitioner, or group
practice, who makes a referral.
(7)
"Rental or lease of office space" means payments made for the rental or lease
of utilities, use of equipment, and secretarial and support staff.
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