reglab/statecodes huggingface dataset:
2023 Maryland Statutes › Health - General › Title 1 - Definitions; General Provisions › Subtitle 1 - Definitions › Section 1-101 - Definitions

(a)    In this article the following words have the meanings indicated.
(b)    “County” means a county of this State and, unless expressly provided otherwise, Baltimore City.
(c)    “Department” means the Maryland Department of Health.
(d)    “Domestic partner” means an individual who meets the requirements of § 6–101 of this article.
(e)    “Health officer” means, unless expressly provided otherwise, the Baltimore City Commissioner of Health or the health officer of a county.
(f)    “Includes” or “including” means includes or including by way of illustration and not by way of limitation.
(g)    “Local health planning agency” means the health department of a jurisdiction or a body designated by the local health department to perform health planning functions.
(h)    “Medical examiner” means:
(1)    The Chief Medical Examiner;
(2)    The Deputy Chief Medical Examiner;
(3)    Any assistant medical examiner; or
(4)    Any deputy medical examiner.
(i)    “Person” means an individual, receiver, trustee, guardian, personal representative, fiduciary, or representative of any kind and any partnership, firm, association, corporation, or other entity.
(j)    “Physician” means an individual who is authorized under the Maryland Medical Practice Act to practice medicine in this State.
(k)    “Secretary” means the Secretary of Health.
(l)    “State” means:
(1)    A state, possession, or territory of the United States;
(2)    The District of Columbia; or
(3)    The Commonwealth of Puerto Rico.
2023 Maryland Statutes › Health - General › Title 1 - Definitions; General Provisions › Subtitle 2 - General Provisions › Section 1-201 - Verification

(a)    A requirement in this article that a document be verified means that the document shall be verified by a declaration made under the penalties of perjury that the matters and facts contained in the document are true to the best of the knowledge, information, and belief of the individual making the declaration.
(b)    The verification shall be made:
(1)    Before an individual authorized to administer oaths; or
(2)    By a signed statement of verification that:
(i)    Is in the document or attached to and made part of the document; and
(ii)    States that the statement is made under the penalties for perjury.
(c)    If the procedures provided in subsection (b)(2) of this section are used, the statement of verification subjects the individual making the statement to the penalties for perjury to the same extent as if the statement had been verified under oath before an individual authorized to administer oaths.
2023 Maryland Statutes › Health - General › Title 1 - Definitions; General Provisions › Subtitle 2 - General Provisions › Section 1-202 - Compliance With Workers' Compensation Act

Before any license or permit may be issued under this article to an employer to engage in an activity in which the employer may employ a covered employee, as defined in § 9-101 of the Labor and Employment Article, the employer shall file with the issuing authority:
(1)    A certificate of compliance with the Maryland Workers’ Compensation Act; or
(2)    The number of a workers’ compensation insurance policy or binder.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part I - General Provisions › Section 2-102 - Secretary of Health

(a)    The head of the Department is the Secretary of Health, who shall be appointed by the Governor with the advice and consent of the Senate.
(b)    (1)    The Secretary serves at the pleasure of the Governor and is responsible directly to the Governor. The Secretary shall advise the Governor on all matters assigned to the Department and is responsible for carrying out the Governor’s policies on these matters.
(2)    The Secretary is responsible for the operation of the Department and shall establish guidelines and procedures to promote the orderly and efficient administration of the Department. The Secretary may establish, reorganize, or abolish areas of responsibility in the Department as necessary to fulfill the duties assigned to the Secretary.
(c)    The Secretary is entitled to the salary provided in the State budget.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part I - General Provisions › Section 2-103 - Deputy Secretaries, Assistant Secretaries, Consultants, and Other Staff

(a)    (1)    With the approval of the Governor, the Secretary shall appoint the following five deputy secretaries:
(i)    The Deputy Secretary for Behavioral Health;
(ii)    The Deputy Secretary for Health Care Financing;
(iii)    The Deputy Secretary for Operations;
(iv)    The Deputy Secretary for Public Health Services; and
(v)    The Deputy Secretary for Developmental Disabilities.
(2)    The deputy secretaries serve at the pleasure of the Secretary.
(3)    The deputy secretaries are entitled to the salary provided in the State budget.
(4)    The deputy secretaries have the duties provided by law or delegated by the Secretary.
(b)    (1)    The Secretary may employ a staff in accordance with the State budget.
(2)    Each deputy secretary and professional consultant is appointed by and serves at the pleasure of the Secretary.
(3)    Except as provided in paragraph (5) of this subsection or otherwise by law, the Secretary shall appoint and remove all other staff in accordance with the provisions of the State Personnel and Pensions Article.
(4)    The appointment or removal of staff of any unit in the Department is subject to the approval of the Secretary. As to any unit in the Department, the Secretary may delegate this authority to the head of that unit.
(5)    All personnel in the Department, Grade 18 and above, who administer or direct a program, shall:
(i)    Be in the executive service, management service, or special appointments in the State Personnel Management System; and
(ii)    Be appointed by, and serve at the pleasure of, the Secretary.
(6)    All personnel in the Department, Grade 18 and above, who administer or direct a program, shall disclose all other employment and compensation outside the Department to the Secretary. An individual under this paragraph may not be employed or receive compensation outside the Department that would create a conflict of interest, an appearance of a conflict of interest, or impair the impartiality and independence of judgment of the individual.
(c)    In determining the staff-to-resident ratio in any residential facility that the Department operates, the number of residents shall be the total of the residents who are physically present and who are on leave of 18 days or less.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part I - General Provisions › Section 2-105 - Establishment of General Policy

(a)    The Secretary shall establish general policy for, and adopt standards to promote and guide the development of, the physical and mental hygiene services of this State and its subdivisions.
(b)    The Secretary is responsible for the health interests of the people of this State and shall supervise generally the administration of the health laws of this State and its subdivisions.
(c)    The Secretary shall adopt and revise as necessary a State health improvement plan that includes the following:
(1)    A description of the components that should comprise the health care system;
(2)    The goals and policies for Maryland’s health care system;
(3)    Identification of unmet needs and excess services for facilities and services not regulated by the certificate of need program; and
(4)    An assessment of the financial resources required and available for the health care system.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part I - General Provisions › Section 2-106 - Units in Department; Secretary's Authority Over Units

(a)    The following units are in the Department:
(1)    Anatomy Board.
(2)    Behavioral Health Administration.
(3)    Developmental Disabilities Administration.
(4)    Health Services Cost Review Commission.
(5)    Maryland Psychiatric Research Center.
(6)    Postmortem Examiners Commission.
(7)    Board of Examiners for Audiologists.
(8)    Board of Chiropractic Examiners.
(9)    Board of Dental Examiners.
(10)    Board of Dietetic Practice.
(11)    Board of Electrologists.
(12)    Board of Morticians.
(13)    Board of Nursing.
(14)    Board of Examiners of Nursing Home Administrators.
(15)    Board of Occupational Therapy Practice.
(16)    Board of Examiners in Optometry.
(17)    Board of Pharmacy.
(18)    Board of Physical Therapy Examiners.
(19)    Board of Physicians.
(20)    Board of Podiatry Examiners.
(21)    Board of Professional Counselors and Therapists.
(22)    Board of Examiners of Psychologists.
(23)    Board of Social Work Examiners.
(24)    Board of Examiners for Speech–Language Pathologists.
(b)    The Department also includes every other unit that is in the Department under any other law.
(c)    The Secretary has the authority and powers specifically granted to the Secretary by law over the units in the Department. All authority and powers not so granted to the Secretary are reserved to those units free of the control of the Secretary.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part I - General Provisions › Section 2-107 - Counsel to Department

(a)    The Attorney General is legal adviser to the Department.
(b)    The Attorney General shall assign to the Department the number of assistant attorneys general authorized by law to be assigned to the Department and any additional ones necessary to give effective legal advice and counsel. The Attorney General also shall designate an assistant attorney general as counsel to the Department.
(c)    The counsel to the Department may have no duty other than to give the legal aid, advice, and counsel required by the Secretary and any other official of the Department, to supervise the other assistant attorneys general assigned to the Department, and to perform for the Department the duties that the Attorney General assigns. The counsel shall perform these duties subject to the control and supervision of the Attorney General. After the Attorney General designates the counsel to the Department, the Attorney General may not reassign the counsel without consulting the Secretary.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 1 - Organization and General Authority of Department › Part II - Deficiencies in Services and Facilities › Section 2-108 - Powers of Secretary

(a)    On the Secretary’s initiative or on request of a community or voluntary, nonprofit organization, the Secretary may conduct a survey to identify any area in this State that has a substantial deficiency in general or specific medical or health care facilities, staff, or services.
(b)    In cooperation with appropriate county and State groups, the Secretary may provide the community or organization with counsel and other help to establish medical or health care facilities or services and to recruit medical or health care staff in an underserved area identified as a result of the survey conducted in accordance with subsection (a) of this section.
(c)    If the counsel and other help provided under subsection (b) of this section do not result in feasible or successful proposals, or if other action is necessary to assure the public health of the underserved area, the Secretary may:
(1)    Provide the needed health care facilities, staff, or services by contract with one or more physicians, hospitals, or other medical groups or personnel; or
(2)    To facilitate the provision of State health care services to the underserved area, approve a contract or other written arrangement with a public or private health care entity, including:
(i)    A federally qualified health center;
(ii)    A health care facility, as defined in § 19–114 of this article;
(iii)    A health benefit plan or insurance carrier;
(iv)    A health maintenance organization;
(v)    A managed care organization; and
(vi)    Any other entity that finances the provision of or delivers health care services to the area.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 3 - Local Health Services Funding › Section 2-302 - Amount of Funding

(a)    The funding required in the State budget for local health services, exclusive of special fund and federal appropriations, shall be at least the amount set forth in subsection (b) of this section.
(b)    The funding shall be:
(1)    For fiscal years 2019, 2020, 2021, 2022, 2023, and 2024, the amount of funding provided through the formula for the preceding fiscal year adjusted for:
(i)    Inflation, as measured by the Consumer Price Index (All Urban Consumers), on June 30 of the second preceding fiscal year, calculated by the Bureau of Labor Statistics of the U.S. Department of Labor; and
(ii)    Population growth, as measured by the growth in the total population of the State on June 30 of the second preceding fiscal year, according to the most recent statistics available through the U.S. Department of Commerce;
(2)    For fiscal year 2025, $70,000,000, to be distributed to each municipality or subdivision in the same proportion as the fiscal year 2024 funding distributed to each municipality or subdivision;
(3)    For fiscal year 2026, $80,000,000, to be distributed to each municipality or subdivision in the same proportion as the fiscal year 2025 funding distributed to each municipality or subdivision; and
(4)    For fiscal year 2027 and each subsequent fiscal year, the greater of:
(i)    The funding provided by the formula for the immediately preceding fiscal year; or
(ii)    The actual funds appropriated for the immediately preceding fiscal year, adjusted for:
1.    Inflation, as measured by the Consumer Price Index (All Urban Consumers), on June 30 of the second immediately preceding fiscal year, calculated by the Bureau of Labor Statistics of the U.S. Department of Labor; and
2.    Population growth, as measured by the growth in the total population of the State on June 30 of the second immediately preceding fiscal year, according to the most recent statistics available through the U.S. Department of Commerce.
(c)    For fiscal year 2027 and each subsequent fiscal year, no subdivision may receive less State funding for local health services under this section than that subdivision received in fiscal year 2026.
(d)    The Secretary shall, in consultation with local health department directors, adopt regulations to guide the distribution of the funding required under this section. The regulations shall give consideration to appropriate measures of community health need, local funding effort, and other relevant factors.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 3 - Local Health Services Funding › Section 2-303 - Local Matching Funds

As to appropriations required by this subtitle, a local match shall be required as a condition of any distribution to a subdivision; however, the local match percentage required by the Secretary of Health may not exceed the local match percentage required for the subdivision for fiscal year 1996.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 3 - Local Health Services Funding › Section 2-304 - Programs

The appropriations described in this subtitle shall be used for programs, including related administrative expenses, directed at the following:
(1)    Communicable disease control services;
(2)    Environmental health services;
(3)    Family planning services;
(4)    Maternal and child health services;
(5)    Wellness promotion services;
(6)    Adult health and geriatric services;
(7)    Data management and exchange services regarding communicable diseases and other health matters, as allowed under federal and State law;
(8)    Providing protective equipment for nurses, physician assistants, physicians, and other health care personnel in contact with patients;
(9)    Providing equipment, medication, and other materials determined to be appropriate to prepare for potential communicable disease emergencies, or other public health emergencies; and
(10)    Administration and communication services associated with the provision of the services described in items (1) through (9) of this section.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 4 - Local Health Planning Agencies › Section 2-401 - Local Health Planning Agency

(a)    A local health planning agency shall:
(1)    Develop a local health plan by assessing local health needs and resources; and
(2)    Provide input into the development of statewide criteria and standards for certificate of need and health planning.
(b)    The Department may require that in developing local health plans, each local health planning agency:
(1)    Use data compatible with State data and data used by other local health planning agencies;
(2)    Meet applicable planning specifications; and
(3)    Work with other local health planning agencies to ensure consistency among local health plans.
(c)    Subject to the annual State budget, the Department shall provide funding to local health planning agencies for implementation of the functions under this section and any other functions required by the Department or the Maryland Health Care Commission.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-501 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “Abuse” means provider practices that are inconsistent with sound fiscal, business, or medical practices and result in unnecessary costs to a program, or in reimbursement for services that are not medically necessary or that fail to meet professionally recognized health care standards.
(c)    “Claim” means a request or demand for money, property, or services made under contract or otherwise, by a contractor, grantee, provider, or other person seeking money for the provision of health services if:
(1)    The State or Department provides any portion of the money or property that is requested or demanded; or
(2)    The State or Department reimburses the contractor, grantee, provider, or other person for any portion of the money or property that is requested or demanded.
(d)    “Employee” means any individual who performs services for, or under the control or direction of, a provider for wages or other remuneration.
(e)    (1)    “Fraud” means an intentional material deception or misrepresentation made by a person with the knowledge that the deception or misrepresentation could result in some unauthorized benefit or payment.
(2)    “Fraud” includes any act that constitutes fraud under applicable State or federal law.
(e–1)    “Office” means the Maryland Office of the Inspector General for Health established under § 2–502 of this subtitle.
(f)    “Program” means the Medical Assistance Program, the Cigarette Restitution Fund Program, the Developmental Disabilities Administration, the Behavioral Health Administration, the Prevention and Health Promotion Administration, or any other unit of the Department that pays a provider for a service rendered or claimed to have been rendered to a recipient.
(g)    (1)    “Provider” means:
(i)    An individual licensed or certified under the Health Occupations Article to provide health care;
(ii)    A licensed facility that provides health care to individuals;
(iii)    Any other person who or entity that provides health care, products, or services to a program recipient; or
(iv)    A contractor, subcontractor, or vendor who directly or indirectly provides the Department or its recipients supplies, drugs, equipment, or services.
(2)    “Provider” does not include a State agency that receives grant funding from or through the Department if that agency has in place a corporate compliance program that meets departmental requirements.
(h)    “Recipient” means an individual who receives benefits under a program.
(i)    “Recovery” means the repayment of money to the Department by a provider through return, reimbursement, recoupment, withholding of future payments, offsets, or any other method.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-502 - Office of Inspector General Established

(a)    There is a Maryland Office of the Inspector General for Health.
(b)    The Office is an independent unit of the State.
(c)    (1)    Subject to paragraph (2) of this subsection, the Office shall have access to the following services of the Department:
(i)    Information technology;
(ii)    Budget and finance;
(iii)    Human resources;
(iv)    Police;
(v)    Procurement; and
(vi)    Support services.
(2)    The Office shall, in consultation with the Department, develop policies and adopt regulations regarding the use and confidentiality of the services listed in paragraph (1) of this subsection.
(d)    The Office shall:
(1)    Maintain a physical location within the Department; and
(2)    Develop policies and adopt regulations regarding the use and confidentiality of the location of the Office.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-502.1 - Inspector General in Office of the Inspector General for Health -- Appointment of Individual -- Restrictions on Outside Political Office -- Qualifications -- Removal

(a)    There is an Inspector General in the Maryland Office of the Inspector General for Health.
(b)    (1)    An individual is eligible to be the Inspector General only if the individual executes an affidavit stating that the individual will not accept appointment to, or be a candidate for, a State or local office:
(i)    During the period of service as the Inspector General; and
(ii)    For at least 3 years immediately after the individual last serves as the Inspector General.
(2)    The Inspector General shall renew the affidavit every 2 years during the period of service.
(3)    A failure to renew the affidavit under this subsection shall subject the Inspector General to removal from office under this section.
(c)    (1)    The Inspector General shall be appointed unanimously by the Governor, the Attorney General, and the State Treasurer, subject to the advice and consent of the Senate.
(2)    The term of the Inspector General is 5 years, beginning July 1 after the appointment of the Inspector General.
(3)    At the end of a term, the Inspector General shall continue to serve until a successor is appointed.
(4)    If a vacancy occurs in the Office, an interim Inspector General shall be appointed as successor to serve for the remainder of the unexpired term.
(d)    The Inspector General may be removed unanimously by the Governor, the Attorney General, and the State Treasurer for:
(1)    Misconduct in office;
(2)    Persistent failure to perform the duties of the Office; or
(3)    Conduct prejudicial to the proper administration of justice.
(e)    (1)    Subject to paragraph (2) of this subsection, the Inspector General must be professionally qualified through experience or education in at least one of the following areas:
(i)    Law;
(ii)    Auditing;
(iii)    Government operations;
(iv)    Financial management; or
(v)    Health policy.
(2)    If the Inspector General is professionally qualified in the area of health policy, the Inspector General also must be professionally qualified through experience or education in at least one of the other areas listed in paragraph (1) of this subsection.
(f)    (1)    The Inspector General is entitled to the salary provided in the State budget.
(2)    Funding for the Office shall be as provided in the State budget.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-502.2 - Compliance Officer -- Designation -- Duties

(a)    There is a Compliance Officer within the Maryland Office of the Inspector General for Health.
(b)    (1)    The Compliance Officer shall be designated by the Inspector General.
(2)    The Compliance Officer shall be professionally qualified through experience or education in at least one of the following areas:
(i)    Administrative management;
(ii)    Health care compliance standards; or
(iii)    Public health.
(c)    The Compliance Officer shall ensure that units and employees of the Department comply with:
(1)    Best practices in health care, public health, and government administration; and
(2)    Laws, regulations, and Department policies.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-503 - Duties of Inspector General

(a)    The Inspector General:
(1)    May investigate fraud, waste, abuse of departmental funds, and behavior in the Department that threatens public safety or demonstrates negligence, incompetence, or malfeasance;
(2)    Shall cooperate with and coordinate investigative efforts with the Medicaid Fraud Control Unit and where a preliminary investigation establishes a sufficient basis to warrant referral, shall refer such matters to the Medicaid Fraud Control Unit; and
(3)    Shall cooperate with and coordinate investigative efforts with departmental programs and other State and federal agencies to ensure a provider is not subject to duplicative audits.
(b)    (1)    The Inspector General or a designated Assistant Inspector General may subpoena any person or evidence, administer oaths, and take depositions and other testimony for the purpose of investigating fraud, waste, abuse of departmental funds, or behavior in the Department that threatens public safety or demonstrates negligence, incompetence, or malfeasance.
(2)    If a person fails to comply with a lawful order or subpoena issued under this subsection, on petition of the Inspector General or a designated Assistant Inspector General, a court of competent jurisdiction may compel:
(i)    Compliance with the order or subpoena; or
(ii)    Testimony or the production of evidence.
(c)    Within 30 business days after receiving a complaint or allegation, the Inspector General, the Compliance Officer, or a designated Assistant Inspector General shall respond to the individual who filed the complaint or allegation with:
(1)    A preliminary indication of whether the Office of the Inspector General is able to investigate the complaint or allegation; and
(2)    If the Office of the Inspector General is unable to investigate the complaint or allegation:
(i)    The reason for not being able to investigate, unless providing the reason would have a negative impact on or jeopardize an investigation being conducted by the Office of the Inspector General, a managed care organization, another unit of government, or law enforcement; and
(ii)    The contact information for the Office of Legislative Audits Fraud Hotline.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-504 - Additional Duties

The Inspector General, in collaboration with the appropriate departmental program, may:
(1)    Take necessary steps to recover any mistaken claims paid or payments obtained in error or fraudulent claims paid to or obtained by a provider; and
(2)    Take necessary steps to recover the cost of benefits mistakenly paid or obtained in error, or fraudulently paid to or obtained by a recipient.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-505 - Civil Liability

(a)    A person is not civilly liable for:
(1)    Making a report in good faith of fraud, waste, or abuse; or
(2)    Participating in any investigation related to fraud, waste, or abuse.
(b)    (1)    This subsection does not apply to an employee as defined in § 1-501(c) of the Health Occupations Article or a State employee.
(2)    A provider may not take a retaliatory action against an employee because the employee:
(i)    Discloses or threatens to disclose to a supervisor or to a public body an activity, policy, or practice of the provider that the employee reasonably believes is in violation of this subtitle or a regulation adopted under this subtitle;
(ii)    Provides information to, or testifies before, a public body conducting an investigation, hearing, or inquiry into a suspected violation by the provider under this subtitle or a regulation adopted under this subtitle; or
(iii)    Objects to or refuses to participate in any activity, policy, or practice that the employee reasonably believes is in violation of this subtitle or regulations adopted under this subtitle.
(3)    Any employee who is subject to an action in violation of paragraph (2) of this subsection may institute a civil action in the county where:
(i)    The alleged violation occurred;
(ii)    The employee resides; or
(iii)    The provider maintains its principal office in the State.
(4)    The action shall be brought within 1 year after the alleged violation of paragraph (2) of this subsection or within 1 year after the employee first became aware of the alleged violation of paragraph (1) of this subsection.
(5)    In any action brought under this subsection, a court may:
(i)    Issue an injunction to restrain continued violation of this subsection;
(ii)    Reinstate the employee to the same or an equivalent position held before the violation of paragraph (2) of this subsection;
(iii)    Remove any adverse personnel record entries based on or related to the violation of paragraph (2) of this subsection;
(iv)    Reinstate full fringe benefits and seniority rights;
(v)    Require compensation for lost wages, benefits, and other remuneration; and
(vi)    Assess reasonable attorney’s fees and other litigation expenses against:
1.    The provider, if the employee prevails; or
2.    The employee, if the court determines that the action was brought by the employee in bad faith and without basis in law or fact.
(6)    A provider shall:
(i)    Conspicuously display notices of its employee protections under this subsection; and
(ii)    Use appropriate means to inform its employees of the protections and obligations provided under this subsection.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 5 - Health Program Integrity and Recovery Activities › Section 2-506 - Annual Report on Office Activities

On or before December 1 each year, the Office shall submit a report to the Secretary, the Governor, and, in accordance with § 2–1257 of the State Government Article, the Senate Budget and Taxation Committee, the Senate Finance Committee, the House Appropriations Committee, the House Health and Government Operations Committee, and the Joint Audit and Evaluation Committee on:
(1)    The Office’s activities during the immediately preceding fiscal year, including:
(i)    Investigations of fraud, waste, and abuse of departmental funds undertaken by the Office, including specific findings and recommendations related to the investigations;
(ii)    A summary of matters referred to the Medicaid Fraud Control Unit by the Office;
(iii)    Recoveries by the Office of mistaken claims paid or payments obtained in error or fraudulent claims paid to or obtained by a provider;
(iv)    Recoveries by the Office of the cost of benefits mistakenly paid or obtained in error, or fraudulently paid to or obtained by a recipient; and
(v)    A summary of matters referred to prosecutive authorities and the resulting prosecutions and convictions; and
(2)    Any regulatory or statutory changes necessary to ensure compliance with applicable federal and State laws.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-603 - Civil Action

(a)    If the State finds that a person has violated or is violating § 2–602(a) of this subtitle, the State may file a civil action in a court of competent jurisdiction within the State against the person.
(b)    In filing a civil action under this section, the State may seek:
(1)    The penalties provided under § 2–602(b) of this subtitle; and
(2)    Subject to the guidelines set forth in § 2–605(a)(4) of this subtitle, court costs and attorney’s fees.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-606 - Private Cause of Action -- Restrictions

(a)    No court in this State shall have jurisdiction over an action filed under § 2–604 of this subtitle against any member of the Legislative Branch or the Judiciary of the State, any member of the Governor’s Executive Council, the Attorney General, the Comptroller, or the State Treasurer if the action is based on evidence or information known to the State when the action was filed.
(b)    A civil action may not be brought under this subtitle by a person who is or was a public employee or public official if the allegations of the action are based substantially on:
(1)    Allegations of wrongdoing or misconduct that the person had a duty or obligation to report or investigate within the scope of the person’s public employment or office; or
(2)    Information or records to which the person had access as a result of the person’s public employment or office.
(c)    A person may not bring an action under § 2–604 of this subtitle that is based on allegations or transactions that are the subject of a civil suit or an administrative civil money penalty proceeding in which the State is already a party.
(d)    (1)    Except as provided in paragraphs (2) and (3) of this subsection, no court in this State shall have jurisdiction over an action filed under § 2–604 of this subtitle that is based on the public disclosure of allegations or transactions:
(i)    In a criminal, civil, or an administrative hearing;
(ii)    In a legislative or an administrative report, a hearing, an audit, or an investigation; or
(iii)    From the news media.
(2)    Paragraph (1) of this subsection does not apply if the action is initiated by a person who:
(i)    Has direct and independent knowledge of the information on which the allegations are based; and
(ii)    Has voluntarily provided the information to the State before filing an action under § 2–604 of this subtitle that is based on the information.
(3)    The State, through the Attorney General, may file a civil action under § 2–603 of this subtitle based on the public disclosure described in paragraph (1) of this subsection.
(e)    The State is not liable for expenses that a person incurs in bringing an action under § 2–604 of this subtitle.
(f)    A person who is or was employed by the State, a local government, or any other political subdivision of the State as an auditor, investigator, attorney, financial officer, or contracting officer may not bring an action under § 2–604 of this subtitle that is based on allegations or transactions that the person discovered or learned of while acting in the person’s capacity as an auditor, investigator, attorney, financial officer, or contracting officer for the State, local government, or other political subdivision of the State.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-608 - Notice of Protections and Obligations

An employer shall:
(1)    Conspicuously display notices of the protections provided to and obligations required of its employees under this subtitle; and
(2)    Use any appropriate means to inform its employees of the protections and obligations provided under this subtitle.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-609 - Procedural Matters

(a)    A civil action filed under this subtitle may not be filed after the later of:
(1)    6 years after the date on which the underlying violation of § 2–602(a) of this subtitle occurred; or
(2)    3 years after the date when facts material to the right of action are known by the relator, the State’s Inspector General, or the Director of the State’s Medicaid Fraud Control Unit or reasonably should have been known, but in no event more than 10 years after the date on which the underlying violation of § 2–602(a) of this subtitle is committed.
(b)    A civil action may be filed under this subtitle for activity that occurred prior to October 1, 2010, if the limitations period under subsection (a) of this section has not lapsed.
(c)    If the State elects to intervene and proceed with an action brought under this subtitle, the State, through the Office of the Attorney General, may:
(1)    File its own complaint; or
(2)    Amend the complaint of the person who brought the action to clarify, add detail to the complaint, or add additional claims to the complaint.
(d)    To the extent that the claim of the State arises out of the conduct, transactions, or occurrences set forth, or attempted to be set forth by a person, a State pleading relates back to the filing date of the complaint of the person who originally brought the action.
(e)    In an action filed under this subtitle, all essential elements of the cause of action, including damages, shall be proven by a preponderance of the evidence.
(f)    Notwithstanding any other provision of law or rule of procedure or evidence in the Maryland Rules, a final judgment rendered in favor of the State in any criminal proceeding charging fraud or false statements, whether on a verdict after trial or on a plea of guilty or nolo contendere, shall stop the defendant from denying the essential elements of the offense in any action filed under this subtitle that involves the same act, transaction, or occurrence as in the criminal proceeding.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-610 - In General

(a)    Any remedy provided under this subtitle is in addition to any other appropriate legal or equitable relief provided under any other applicable State or federal statute or regulation.
(b)    (1)    The State shall make all reasonable efforts to coordinate any investigation of an alleged violation under this subtitle with any investigation conducted by the federal government involving the same violation.
(2)    The State’s objective shall be to avoid unnecessary duplication of effort on the part of the person alleged to have committed the violation and to minimize the burden of the investigation on the person.
(c)    (1)    Except as provided under paragraph (2) of this subsection, the Comptroller shall deposit any civil penalty or damages collected under this subtitle in the General Fund of the State.
(2)    (i)    If a violation of this subtitle affects any of the following funds, the Comptroller shall deposit any civil penalty or damages collected by the State under this title into the affected fund:
1.    A fund that is not subject to § 7–302 of the State Finance and Procurement Article;
2.    A special fund requiring the reversion of appropriated funds to the special fund under § 7–304 of the State Finance and Procurement Article;
3.    A fund under the jurisdiction of the Board of Trustees for the State Retirement and Pension System; or
4.    A fund under the jurisdiction of the State Employee and Retiree Health and Welfare Benefits Program.
(ii)    If more than one fund is affected by a violation of this subtitle, the Comptroller shall deposit any civil penalty or damages collected by the State into the appropriate fund or the General Fund of the State on a pro rata basis.
(d)    The Department or the Inspector General of the Department may adopt regulations to carry out the provisions of this subtitle.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 6 - False Claims Against State Health Plans and State Health Programs › Section 2-611 - Annual Reports

(a)    Beginning October 1, 2010, the Inspector General of the Department and the Director of the Medicaid Fraud Control Unit in the Office of the Attorney General shall report annually to the General Assembly, in accordance with § 2–1257 of the State Government Article, the following information for the previous fiscal year:
(1)    The number of civil actions filed under this subtitle;
(2)    The number of civil actions under this subtitle in which a judgment was entered, whether by settlement or adjudication; and
(3)    The number of claims made by the State based on alleged violations of § 2–602(a) of this subtitle that are settled without the filing of a civil action under this subtitle.
(b)    Unless the action is under seal in accordance with § 2–604 of this subtitle, for each civil action reported under subsection (a)(1) or (2) of this section, the report shall state:
(1)    Whether the action was filed by the State or by a person on behalf of the State and, if filed by a person, whether the State intervened and proceeded with the action;
(2)    The name of the defendant and the following information about the defendant:
(i)    The number of employees and any other data relevant to the size of the defendant;
(ii)    The amount of payments made to the defendant in the year prior to the filing of the action from State health plans and, to the extent known by the Inspector General and the Medicaid Fraud Control Unit, from other sources; and
(iii)    Whether the defendant is a minority–owned business enterprise as defined by § 14–301 of the State Finance and Procurement Article;
(3)    A description of the violation or alleged violation of § 2–602 of this subtitle; and
(4)    The amount sought in the action and, if applicable, the amount for which the defendant is liable under a settlement agreement or court order.
(c)    For each claim reported under subsection (a)(3) of this section, the report shall state:
(1)    A description of the violation or alleged violation of § 2–602 of this subtitle;
(2)    The resolution of the claim;
(3)    The amount, if any, the person against whom the claim was made agreed to pay in settlement of the claim; and
(4)    The amount, if any, collected by the State.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 7 - Use of Extrapolation in Recovery of Health Claim Overpayments › Section 2-701 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “Claim” has the meaning stated in § 2–501 of this title.
(c)    “Extrapolation” means the process of estimating an unknown value by projecting, with a calculated precision or margin of error, the results of the review of a sample to the universe from which the sample was drawn using a statistically valid sampling methodology.
(d)    “Federal government” means an agency of the United States government or a contractor retained by the agency of the United States government.
(e)    “Overpayment” means a payment that:
(1)    Is made by the Department to a provider for services or goods for which the provider submitted a claim to the Department;
(2)    Is found to be incorrect; and
(3)    Results in a payment greater than that to which the provider is entitled.
(f)    “Program” has the meaning stated in § 2–501 of this title.
(g)    “Provider” has the meaning stated in § 2–501 of this title.
(h)    “Statistically valid sampling methodology” means a methodology used for extrapolation that has a confidence level of 90% or greater and is validated by a statistician who possesses at least a master’s degree in statistics.
(i)    “Universe” means a defined population of claims submitted by a provider to the Department and paid to the provider by the Department during a specified time period.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 7 - Use of Extrapolation in Recovery of Health Claim Overpayments › Section 2-702 - Use of Extrapolation During Audits to Recover Overpayments

(a)    Subject to the requirements of this subtitle, the Inspector General, or a contractor or an agent acting on behalf of the Inspector General, may use extrapolation during an audit to recover an overpayment from a provider if:
(1)    The federal government has also conducted an audit of the program for overpayment; and
(2)    The monetary recovery amount determined to be due by the program to the federal government is based on the federal government’s use of extrapolation.
(b)    An audit conducted by the Inspector General or a contractor or agent acting on behalf of the Inspector General under subsection (a) of this section shall be limited to the scope of the federal audit, including claims for the same audit time period and the same type of claims.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 7 - Use of Extrapolation in Recovery of Health Claim Overpayments › Section 2-703 - When Extrapolation Permitted

(a)    On a finding of an overpayment to a provider, the Inspector General may not use extrapolation unless there is a determination of a sustained or high level of payment error, as defined by regulation.
(b)    When using extrapolation to determine an overpayment, the sample to be used may not include claims:
(1)    In which the alleged overpayment would have no fiscal impact on the entire sample;
(2)    That were submitted in accordance with the Department’s, Inspector General’s, or program’s directives, policies, guidelines, or regulations; or
(3)    That are the result of an unintentional overlap in services among unrelated providers caused by circumstances beyond the control of the provider that is subject to the audit, in which case the Inspector General may recover the original overpayment.
2023 Maryland Statutes › Health - General › Title 2 - Maryland Department of Health › Subtitle 7 - Use of Extrapolation in Recovery of Health Claim Overpayments › Section 2-704 - Methodology; Audit Team

(a)    The Inspector General or a contractor or an agent of the Inspector General that conducts an audit under this subtitle in which extrapolation may be used shall:
(1)    Perform the audit in accordance with a methodology used by the federal government or conducted in accordance with Generally Accepted Auditing Standards (GAAS) and the Statement on Accounting Standards (SAS);
(2)    Use a statistically valid sampling methodology; and
(3)    Meet the following qualifications:
(i)    Have at least 3 years of auditing experience;
(ii)    Have experience in the procedural coding program used for the claim;
(iii)    Be familiar, either independently or through training by the provider, with the format and content of paper and electronic medical records and claim forms used by the provider; and
(iv)    Have general knowledge of the particular health care item or service that is the subject of the audit and the program rules that govern the health care item or service at the time the item or service was provided.
(b)    (1)    If the medical necessity of the claim is the subject of the audit, the entity that conducts the audit shall include as part of the audit team an individual licensed in the same health occupation as the provider.
(2)    The individual included in the audit team under paragraph (1) of this subsection shall have significant knowledge of the audited procedure but is not required to be in the same specialty or practice area as the audited provider.