(a) Except as provided in subsection (c) of this section and Title 12 of this article, a health care practitioner making a lawful referral shall disclose the existence of the beneficial interest in accordance with provisions of this section. (b) Prior to referring a patient to a health care entity in which the practitioner, the practitioner's immediate family, or the practitioner in combination with the practitioner's immediate family owns a beneficial interest, the health care practitioner shall: (1) Except if an oral referral is made by telephone, provide the patient with a written statement that: (i) Discloses the existence of the ownership of the beneficial interest or compensation arrangement; (ii) States that the patient may choose to obtain the health care service from another health care entity; and (iii) Requires the patient to acknowledge in writing receipt of the statement; (2) Except if an oral referral is made by telephone, insert in the medical record of the patient a copy of the written acknowledgement; (3) Place on permanent display a written notice that is in a typeface that is large enough to be easily legible to the average person from a distance of 8 feet and that is in a location that is plainly visible to the patients of the health care practitioner disclosing all of the health care entities: (i) In which the practitioner, the practitioner's immediate family, or the practitioner in combination with the practitioner's immediate family owns a beneficial interest; and (ii) To which the practitioner refers patients; and (4) Documents in the medical record of the patient that: (i) A valid medical need exists for the referral; and (ii) The practitioner has disclosed the existence of the beneficial interest to the patient. (c) The provisions of this section do not apply to: (1) A health care practitioner when treating a member of a health maintenance organization as defined in § 19-701 of the Health - General Article and the health care practitioner does not have a beneficial interest in the health care entity; or (2) A health care practitioner who refers a patient: (i) To another health care practitioner in the same group practice as the referring health care practitioner; (ii) For in-office ancillary services; or (iii) For health care services provided through or by a health care entity owned or controlled by a hospital. (d) A health care practitioner who fails to comply with any provision of this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000.
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