Current as of: 2010
(a) In this part the following words have the meanings indicated.(b) "False representation" means the knowing and willful: (1) concealing, falsifying, or omitting of a material fact; (2) making of a materially false or fraudulent statement; or (3) use of a document that contains a statement of material fact that the user knows to be false or fraudulent. (c) (1) "Health care service" means health or medical care procedures, goods, or services that: (i) provide testing, diagnosis, or treatment of human disease or dysfunction; or (ii) dispense drugs, medical devices, medical appliances, or medical goods for the treatment of human disease or dysfunction. (2) "Health care service" includes any procedure, goods, or service that is a required benefit of a State health plan. (d) "Representation" includes an acknowledgment, certification, claim, ratification, report of demographic statistics, encounter data, enrollment claims, financial information, health care services available or rendered, and qualifications of a person rendering health care or ancillary services. (e) "Serious injury" means an injury that: (1) creates a substantial risk of death; (2) causes serious permanent or serious protracted disfigurement; (3) causes serious permanent or serious protracted loss of the function of any body part, organ, or mental faculty; (4) causes serious permanent or serious protracted impairment of the function of any bodily member or organ; or (5) involves extreme physical pain. (f) (1) "State health plan" includes: (i) the State Medical Assistance Plan established in accordance with Title XIX of the federal Social Security Act of 1939; (ii) a medical assistance plan established by the State; or (iii) a private health insurance carrier, health maintenance organization, managed care organization as defined in ยง 15-101 of the Health - General Article, health care cooperative or alliance, or other person that provides or contracts to provide health care services that are wholly or partly reimbursed by or are a required benefit of a health plan established in accordance with Title XIX of the federal Social Security Act of 1939 or by the State. (2) "State health plan" includes a person that provides or contracts or subcontracts to provide health care services for an entity described in paragraph (1) of this subsection. Prev | Next________________________________________________________________________
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See also: U.S. Code Provisions: Criminal Law
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