(a)    In this subtitle the following words have the meanings indicated.

(b)    (1)    “Ambulatory surgical facility” means any center, 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 an ambulatory surgery center.

(2)    “Ambulatory surgical facility” does not include:

(i)    The office of one or more health care practitioners seeking only professional reimbursement for the provisions of medical services, unless:

1.    The office operates under contract or other agreement with a payor as an ambulatory surgical facility regardless of whether it is paid a technical or facility fee; or

2.    The office is designated to receive ambulatory surgical referrals in accordance with utilization review or other policies adopted by a payor;

(ii)    Any facility or service owned or operated by a hospital and regulated under Subtitle 2 of this title;

(iii)    The office of a health care practitioner with not more than one operating room if:

1.    The office does not receive a technical or facility fee; and

2.    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:

1.    The office does not receive a technical or facility fee; and

2.    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.

(c)    “Freestanding ambulatory care facility” means:

(1)    An ambulatory surgical facility;

(2)    A freestanding endoscopy facility;

(3)    A freestanding facility utilizing major medical equipment;

(4)    A kidney dialysis center; or

(5)    A freestanding birthing center.

(d)    (1)    “Freestanding birthing center” means a facility that provides nurse midwife services under Title 8, Subtitle 6 of the Health Occupations Article.

(2)    “Freestanding birthing center” does not include:

(i)    A hospital regulated under Subtitle 2 of this title; or

(ii)    The private residence of the mother.

(e)    (1)    “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 payors or Medicare.

(2)    “Freestanding endoscopy facility” does not include:

(i)    The office of one or more health care practitioners unless:

1.    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

2.    The office is designated to receive endoscopic referrals in accordance with utilization review or other policies adopted by a payor; or

(ii)    Any facility or service operated by a hospital and regulated under Subtitle 2 of this title.

(f)    (1)    “Freestanding facility operating major medical equipment” means a facility using major medical equipment.

(2)    “Freestanding facility operating major medical equipment” does not include any facility or service owned or operated by a hospital and regulated under Subtitle 2 of this title.

(g)    “Health care practitioner” means a person who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide medical services in the ordinary course of business or practice of a profession.

(h)    (1)    “Kidney dialysis center” means a facility that provides hemodialysis or chronic peritoneal dialysis.

(2)    “Kidney dialysis center” does not include any facility or service owned or operated by a hospital and regulated under Subtitle 2 of this title.

(i)    “License” means a license issued by the Secretary under this subtitle.

(j)    “Major medical equipment” means:

(1)    Cardiac catheterization equipment;

(2)    A computer tomography (CT) scanner;

(3)    A lithotripter;

(4)    Radiation therapy equipment, including a linear accelerator; or

(5)    A magnetic resonance imager (MRI).

(k)    “Payor” means:

(1)    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 the State in accordance with this article or the Insurance Article;

(2)    A third party administrator or any other entity under contract with a Maryland business to administer health benefits; or

(3)    A self-insured group.

(l)    “Surgical services” has the meaning incorporated in the Centers for Medicare and Medicaid Services State Operations Manual – Guidance for Surveyors: Ambulatory Surgical Centers.