As used in the Health Care Fraud Prevention Act:
1. “Accident and health insurance policy” means any policy, certificate, contract, agreement or other instrument that provides accident and health insurance, as defined in Section 703 of this title, to any person in this state;
2. “Health care provider” means a physician, hospital, ambulatory surgical center, pharmacy, pharmacist, laboratory, or any other state-licensed or state-recognized provider of health care services;
3. “Insured” means any person entitled to reimbursement for expenses of health care services and procedures under an accident and health insurance policy issued by an insurer;
4. “Insurer” means any entity that provides an accident and health insurance policy in this state, including but not limited to a licensed insurance company, a not-for-profit hospital service and medical indemnity corporation, a fraternal benefit society, a multiple employer welfare arrangement, or any other entity subject to regulation by the Insurance Commissioner;
5. ”Perferred provider organization” means any entity defined as a “preferred provider organization (PPO)” in Section 6054 of this title; and
6. “Third-party administrator” means any person defined as an “administrator” in Section 1442 of this title.
Added by Laws 2000, c. 353, § 5, eff. Nov. 1, 2000.
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