Maryland Statutes
Part II - Medicaid Fraud
Section 8-508 - Definitions

(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 § 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.