Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.16 - Carrier Provider Panels - Application Process
Section 31.10.16.02 - Definitions
Universal Citation: MD Code Reg 31.10.16.02
Current through Register Vol. 51, No. 19, September 20, 2024
A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) Carrier.
(a) "Carrier" means:
(i) An insurer;
(ii) A nonprofit health service plan;
(iii) A health maintenance organization;
(iv) A dental plan organization; and
(v) Any other person or organization that provides health benefit plans subject to State regulation.
(b) "Carrier" includes an entity that arranges a provider panel for a carrier.
(2) "Provider" means a health care practitioner or a group of health care practitioners licensed or otherwise authorized by law to provide health care services.
(3) Provider Panel.
(a) "Provider panel" means those providers with which a carrier contracts to provide health care services to the carrier's enrollees under the carrier's health benefit plan.
(b) "Provider panel" does not include an arrangement between a carrier and providers in which a provider may participate solely on the basis of the provider's contracting with the carrier to provide services at a discounted fee-for-service rate.
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