Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 1 › Subtitle 05 - FREESTANDING AMBULATORY CARE FACILITIES › Chapter 10.05.05 - Freestanding Ambulatory Surgical Facilities › Section 10.05.05.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Allied health professional" means an
				  individual who is licensed, certified, or otherwise authorized under Health
				  Occupations Article, Annotated Code of Maryland, to provide health care
				  services, except those individuals who are licensed to practice medicine,
				  dentistry, or podiatry under the Health Occupations Article, Annotated Code of
				  Maryland.
(2) Freestanding
				  Ambulatory Surgical Facility.
(a)
				  "Freestanding ambulatory surgical facility" means a facility, service, office
				  facility, or other entity that:
(i) Operates
				  exclusively for the purpose of providing surgical services to patients
				  requiring a period of postoperative observation but not requiring
				  hospitalization and in which the expected duration of services would not exceed
				  24 hours following admission; and
(ii) Seeks reimbursement from payors as a
				  freestanding ambulatory surgical facility.
(b) "Freestanding ambulatory surgical
				  facility" does not include:
(i) The office of
				  one or more health care practitioners seeking only professional reimbursement
				  for the provision of medical services unless the office operates under contract
				  or other agreement with a payor as a freestanding ambulatory surgical facility,
				  regardless of whether it is paid a technical or facility fee, or the office is
				  designated to receive ambulatory surgical referrals in accordance with
				  utilization review or other policies adopted by a payor;
(ii) A facility or service owned or operated
				  by a hospital and regulated under Health-General Article, Title 19, Subtitle 2,
				  Annotated Code of Maryland;
(iii)
				  The office of a health care practitioner with not more than one operating room
				  if the office does not receive a technical or facility fee, and the operating
				  room is used exclusively by the health care practitioner for patients of the
				  health care practitioner;
(iv) The
				  office of a group of health care practitioners with not more than one operating
				  room if the office does not receive a technical or facility fee, and the
				  operating room is used exclusively by members of the group practice for
				  patients of the group practice; or
(v) An office owned or operated by one or
				  more dentists licensed under the Health Occupations Article, Annotated Code of
				  Maryland, for the sole purpose of practicing dentistry.
(3) Freestanding Endoscopy
				  Facility.
(a) "Freestanding endoscopy
				  facility" means a facility:
(i) For the
				  testing, diagnosis, or treatment of a medical disorder in conjunction with the
				  use of microscopic, endoscopic, or laparoscopic equipment that is inserted in a
				  naturally occurring orifice of the body; and
(ii) That seeks reimbursement as a
				  freestanding endoscopy facility from third-party payors.
(b) "Freestanding endoscopy facility" does
				  not include:
(i) The office of one or more
				  health care practitioners unless the office operates under a contract or other
				  agreement with a payor as a freestanding endoscopy facility, regardless of
				  whether it is paid a technical or facility fee, or the office is designated to
				  receive endoscopic referrals in accordance with utilization review or other
				  policies adopted by a payor; or
(ii) A facility or service operated by a
				  hospital and regulated under Health-General Article, Title 19, Subtitle 2,
				  Annotated Code of Maryland.
(4) "Payor" means:
(a) A health insurer, nonprofit health
				  service plan, or health maintenance organization that holds a certificate of
				  authority to offer health insurance policies or contracts in this State in
				  accordance with Health-General Article, Title 19, Subtitle 7, and the Insurance
				  Article, Annotated Code of Maryland;
(b) A third-party administrator or any other
				  entity, under contract with a Maryland business to administer health benefits;
				  or
(c) A self-insured
				  group.
(5) Surgery.
(a) "Surgery" means a procedure conducted for
				  the purpose of structurally altering the human body by the incision or
				  destruction of tissues and is part of the practice of medicine.
(b) "Surgery" includes:
(i) The diagnostic or therapeutic treatment
				  of conditions or disease processes by any instruments causing localized
				  alteration or transposition of live human tissue which include, lasers,
				  ultrasound, ionizing radiation, scalpels, probes, and needles;
(ii) Cut, burned, vaporized, frozen, sutured,
				  probed, or manipulated tissue by closed reductions for major dislocations or
				  fractures, or otherwise altered by mechanical, thermal, light-based,
				  electromagnetic, or chemical means; or
(iii) Injection of diagnostic or therapeutic
				  substances into body cavities, internal organs, joints, sensory organs, and the
				  central nervous system.
(6) "Surgical
				  services" means surgical procedures performed in a safe manner by qualified
				  physicians who have been granted clinical privileges by the governing body of
				  the ambulatory surgical center in accordance with approved policies and
				  procedures of the ambulatory surgical center.