reglab/statecodes huggingface dataset:
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part II - Health Planning and Development › Section 19-128 - Appeal of Administrative Decision

(a)    (1)    In this section, “aggrieved party” means:
(i)    An interested party who presented written comments on the application to the Commission and who would be adversely affected by the decision of the Commission on the project; or
(ii)    The Secretary.
(2)    The grounds for appeal by the Secretary shall be that the decision is inconsistent with the State health plan or adopted standards.
(b)    (1)    A decision of the Commission shall be the final decision for purposes of judicial review.
(2)    A request for a reconsideration will stay the final decision of the Commission for purposes of judicial review until a decision is made on the reconsideration.
(c)    An aggrieved party may take a direct judicial appeal within 30 days of the final decision of the Commission.
(d)    The Commission is a necessary party to an appeal at all levels of the appeal.
(e)    In the event of an adverse decision that affects its final decision, the Commission may apply within 30 days by writ of certiorari to the Court of Appeals for review where:
(1)    Review is necessary to secure uniformity of decision, as where the same statute has been construed differently by 2 or more judges; or
(2)    There are other special circumstances that render it desirable and in the public interest that the decision be reviewed.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part II - Health Planning and Development › Section 19-129 - Merger or Consolidation of Hospitals

(a)    Notwithstanding the fact that a merger or consolidation may limit free economic competition, the Commission may approve the merger or consolidation of 2 or more hospitals if the merger or consolidation:
(1)    Is not inconsistent with the State health plan or any institution-specific plan;
(2)    Will result in the delivery of more efficient and effective hospital services; and
(3)    Is in the public interest.
(b)    Notwithstanding the fact that a merger or consolidation or the joint ownership and operation of major medical equipment may limit free economic competition, a hospital may engage in a merger or consolidation or the joint ownership of major medical equipment that has been approved by the Commission under this section.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part III - Medical Care Data Collection › Section 19-135 - Cost Control; Clinical Resource Management System

(a)    The Commission may implement a system to encourage health care practitioners to voluntarily control the costs of health care services.
(b)    The Commission may require health care practitioners of selected health care specialties to cooperate with licensed operators of clinical resource management systems that allow health care practitioners to critically analyze their charges and utilization of services in comparison to their peers.
(c)    If the Commission determines that clinical resource management systems are not available in the private sector, the Commission, in consultation with interested parties including payors, health care practitioners, and the Association of Maryland Hospitals and Health Systems, may develop a clinical resource management system.
(d)    The Commission may adopt regulations to govern the licensing of clinical resource management systems to ensure the accuracy and confidentiality of information provided by the system.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part III - Medical Care Data Collection › Section 19-136 - Obtaining Information Relating to the Utilization or Cost of Health Care Services

In any matter that relates to the utilization or cost of health care services rendered by health care practitioners or office facilities, the Commission may:
(1)    Hold a public hearing;
(2)    Conduct an investigation; or
(3)    Require the filing of any reasonable information.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part III - Medical Care Data Collection › Section 19-137 - Investigations to Authenticate Information

If the Commission considers a further investigation necessary or desirable to authenticate information in a report that a health care practitioner or office facility files under this subtitle, the Commission may make necessary further examination of the records or accounts of the health care practitioner or office facility, in accordance with the regulations of the Commission.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part IV - Electronic Health Records -- Regulation and Reimbursement › Section 19-144 - Electronic Advance Directives Services

(a)    To facilitate the use of Web–based technology for electronic advance directives, the Maryland Health Care Commission shall develop criteria for recognizing electronic advance directives services that are authorized to connect to the State–designated health information exchange.
(b)    To be authorized to connect to the State–designated health information exchange, an electronic advance directives service shall:
(1)    Be recognized by the Maryland Health Care Commission;
(2)    Be responsible for all costs associated with connecting to the State–designated health information exchange; and
(3)    Store electronic advance directives that are received by facsimile or other electronic means.
(c)    The State–designated health information exchange may charge electronic advance directives services recognized by the Maryland Health Care Commission a fee for connecting to the State–designated health information exchange.
(d)    The State–designated health information exchange shall ensure that electronic advance directives services do not have access to information stored on the State–designated health information exchange.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1 - Health Care Planning and Systems Regulation › Part V - Examiners of Physician Rating Systems › Section 19-146 - Definitions

(a)    In this Part V of this subtitle the following words have the meanings indicated.
(b)    “Carrier” has the meaning stated in § 15–1301 of the Insurance Article.
(c)    “Enrollee” means an individual entitled to health benefits from a carrier.
(d)    “Physician rating system” has the meaning stated in §  15–1701 of the Insurance Article.
(e)    “Ratings examiner” means an independent entity that is approved by the Commission to review physician rating systems.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1B - Community Integrated Medical Home Program › Section 19-1B-01 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “Advisory body” means the Community Integrated Medical Home Program advisory body.
(c)    “Carrier” has the meaning stated in § 15–1801 of the Insurance Article.
(d)    “Commission” means the Maryland Health Care Commission.
(e)    “Community integrated medical home” means a certified participating patient centered medical home integrated with community–based services and supports provided by certified entities to address social as well as medical determinants of health.
(f)    “Managed care organization” has the meaning stated in § 15–101 of this article.
(g)    “Patient centered medical home” means a primary care practice organized to provide a first, coordinated, ongoing, and comprehensive source of care to patients to:
(1)    Foster a partnership with a qualifying individual;
(2)    Coordinate health care services for a qualifying individual; and
(3)    Exchange medical information with carriers, other providers, and qualifying individuals.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1B - Community Integrated Medical Home Program › Section 19-1B-02 - Program Established

(a)    There is a Community Integrated Medical Home Program.
(b)    The mission of the Community Integrated Medical Home Program is to:
(1)    Keep Maryland families healthy through the use of innovative mapping tools that allow better targeting of resources to those in need;
(2)    Coordinate comprehensive services provided by a participating patient centered medical home with public health resources in local communities across the State; and
(3)    Provide complementary support for qualified individuals between office visits.
(c)    The Community Integrated Medical Home Program shall be administered jointly by the Commission and the Department.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1B - Community Integrated Medical Home Program › Section 19-1B-03 - Community Integrated Medical Home Program Advisory Body

(a)    There is a Community Integrated Medical Home Program advisory body.
(b)    The advisory body shall make recommendations concerning:
(1)    The model, standards, and scope of services for the Community Integrated Medical Home Program;
(2)    The essential elements for implementing the Community Integrated Medical Home Program, including those necessary to attract patient centered medical homes, carriers, managed care organizations, and other payors to participate in the Program;
(3)    The extent and nature of the relationship between the Community Integrated Medical Home Program and patient centered medical homes, carriers, managed care organizations, and other payors; and
(4)    How the Community Integrated Medical Home Program can be financially self–sustaining.
(c)    The advisory body shall include interested stakeholders representing health care provider organizations, consumer advocacy organizations, health professional associations, health occupations boards, carriers, and managed care organizations.
(d)    The Commission and the Secretary, in consultation, shall:
(1)    Appoint the members of the advisory body; and
(2)    Determine the frequency and location of meetings of the advisory body.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 1C - Safety and Community Relations Plans › Section 19-1C-01 - Licensed Facility to Establish and Implement Certain Plans -- Authorization by Department

(a)    Before the Department approves the operation of a facility under this title, including by granting a license to the facility, the Department shall require the facility to establish and implement:
(1)    A safety plan for the safety of the individuals served by the facility; and
(2)    A community relations plan, if the facility is:
(i)    Accredited by an accreditation organization, as defined in § 19–2301 of this title; and
(ii)    Required by the accreditation organization to establish and implement a community relations plan.
(b)    The Department may authorize a facility to satisfy the requirement under:
(1)    Subsection (a)(1) of this section by implementing a safety plan established for the facility for another purpose, including an emergency plan; and
(2)    Subsection (a)(2) of this section by implementing the community relations plan required by the accreditation organization.
(c)    A facility in operation on or before September 30, 2021, shall submit a safety plan on or before October 1, 2023, in accordance with this section.
(d)    Each facility shall revise its safety plan not less than every 5 years.
(e)    A facility may satisfy the requirement under subsection (c) of this section by implementing a safety or emergency plan established for the facility for another purpose.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-201 - Definitions

(a)    In this subtitle the following words have the meanings indicated.
(b)    “All–payer model contract” means the payment model demonstration agreement authorized under § 1115A of the Social Security Act, including any amendments to the agreement, between the State and the federal Center for Medicare and Medicaid Innovation.
(c)    “Commission” means the State Health Services Cost Review Commission.
(d)    “Facility” means, whether operated for a profit or not:
(1)    Any hospital; or
(2)    Any related institution.
(e)    (1)    “Hospital services” means:
(i)    Inpatient hospital services as enumerated in Medicare Regulation 42 C.F.R. § 409.10, as amended;
(ii)    Emergency services, including services provided at a freestanding medical facility licensed under Subtitle 3A of this title;
(iii)    Outpatient services provided at a hospital;
(iv)    Outpatient services, as specified by the Commission in regulation, provided at a freestanding medical facility licensed under Subtitle 3A of this title that has received:
1.    A certificate of need under § 19–120(o)(1) of this title; or
2.    An exemption from obtaining a certificate of need under § 19–120(o)(3) of this title; and
(v)    Identified physician services for which a facility has Commission–approved rates on June 30, 1985.
(2)    “Hospital services” includes a hospital outpatient service:
(i)    Of a hospital that, on or before June 1, 2015, is under a merged asset hospital system;
(ii)    That is designated as a part of another hospital under the same merged asset hospital system to make it possible for the hospital outpatient service to participate in the 340B Program under the federal Public Health Service Act; and
(iii)    That complies with all federal requirements for the 340B Program and applicable provisions of 42 C.F.R. § 413.65.
(3)    “Hospital services” does not include:
(i)    Outpatient renal dialysis services; or
(ii)    Outpatient services provided at a limited service hospital as defined in § 19–301 of this title, except for emergency services.
(f)    (1)    “Related institution” means an institution that is licensed by the Department as:
(i)    A comprehensive care facility that is currently regulated by the Commission; or
(ii)    An intermediate care facility–intellectual disability.
(2)    “Related institution” includes any institution in paragraph (1) of this subsection, as reclassified from time to time by law.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-203 - Membership

(a)    (1)    The Commission consists of 7 members appointed by the Governor.
(2)    Of the 7 members, 4 shall be individuals who do not have any connection with the management or policy of any facility.
(b)    Each member shall be interested in problems of health care.
(c)    (1)    The term of a member is 4 years.
(2)    The terms of members are staggered as required by the terms provided for members of the Commission on July 1, 1982. The terms of those members end as follows:
(i)    2 in 1983;
(ii)    1 in 1984;
(iii)    2 in 1985; and
(iv)    2 in 1986.
(3)    At the end of a term, a member continues to serve until a successor is appointed and qualifies.
(4)    A member who is appointed after a term has begun serves only for the rest of the term and until a successor is appointed and qualifies.
(5)    A member who serves 2 consecutive full 4-year terms may not be reappointed for 4 years after completion of those terms.
(6)    When appointing a member to fill a vacancy due to the expiration of a member’s term, the Governor shall give consideration to, and make appointments when appropriate, that would promote the racial, gender, and geographic diversity of the Commission.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-205 - Executive Director

(a)    With the approval of the Governor, the Commission shall appoint an Executive Director, who is the chief administrative officer of the Commission.
(b)    The Executive Director serves at the pleasure of the Commission.
(c)    Under the direction of the Commission, the Executive Director shall perform any duty or function that the Commission requires.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-206 - Quorum; Meetings; Compensation; Staff

(a)    A majority of the full authorized membership of the Commission is a quorum. However, the Commission may not act on any matter unless at least 4 members in attendance concur.
(b)    The Commission shall meet at least 6 times a year, at the times and places that it determines.
(c)    Each member of the Commission is entitled to:
(1)    Compensation in accordance with the State budget; and
(2)    Reimbursement for expenses under the Standard State Travel Regulations, as provided in the State budget.
(d)    (1)    The Commission may employ a staff in accordance with the State budget.
(2)    The Commission, in consultation with the Secretary, may set the compensation of a Commission employee in a position that:
(i)    Is unique to the Commission;
(ii)    Requires specific skills or experience to perform the duties of the position; and
(iii)    Does not require the employee to perform functions that are comparable to functions performed in other units of the Executive Branch of State government.
(3)    The Secretary of Budget and Management, in consultation with the Commission, shall determine the positions for which the Commission may set compensation under paragraph (2) of this subsection.
(4)    The Deputy Director and each principal section chief of the Commission serve at the pleasure of the Commission.
(5)    The Commission, in consultation with the Secretary, may determine the appropriate job classifications for the Executive Director, Deputy Director, and each principal section chief of the Commission.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-208 - Limitations on Secretary

(a)    The power of the Secretary over plans, proposals, and projects of units in the Department does not include the power to disapprove or modify any decision or determination that the Commission makes under authority specifically delegated by law to the Commission.
(b)    (1)    The power of the Secretary to transfer by rule, regulation, or written directive, any staff, functions, or funds of units in the Department does not apply to any staff, function, or funds of the Commission.
(2)    The Secretary may assess an administrative charge on the Commission to fund services provided to the Commission by the Department.
(3)    The amount to be paid by the Commission to the Department for administrative costs, not to exceed 30.5% of the salaries of the Commission, shall be based on indirect costs or services benefiting the Commission, less overhead costs paid directly by the Commission.
(c)    (1)    The power of the Secretary over the procurement procedure for units in the Department does not apply to the procurement procedure for the Commission.
(2)    Subject to the provisions of paragraph (1) of this subsection, any procurement for services to be performed or for supplies to be delivered to the Commission is subject to the purposes and requirements of the State Finance and Procurement Article.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part I - Definitions; General Provisions › Section 19-210 - Maternal and Child Health Population Health Improvement Fund

(a)    In this section, “Fund” means the Maternal and Child Health Population Health Improvement Fund.
(b)    There is a Maternal and Child Health Population Health Improvement Fund.
(c)    The purpose of the Fund is to invest in maternal and child population health improvements through the Medical Care Programs Administration and the Prevention and Health Promotion Administration.
(d)    The Department and the Commission shall administer the Fund.
(e)    (1)    The Fund is a special, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.
(2)    The State Treasurer shall hold the Fund separately, and the Comptroller shall account for the Fund.
(f)    The Fund consists of:
(1)    A uniform, broad–based assessment of a reasonable amount in hospital rates in order to invest in maternal and child population health improvements under § 19–207 of this subtitle;
(2)    Interest earnings; and
(3)    Any other money from any other source accepted for the benefit of the Fund.
(g)    The Fund may be used only for expenses associated with maternal and child health population health improvements through December 31, 2025.
(h)    (1)    The State Treasurer shall invest the money of the Fund in the same manner as other State money may be invested.
(2)    Any interest earnings of the Fund shall be credited to the Fund.
(i)    Expenditures from the Fund may be made only:
(1)    In accordance with the State budget; and
(2)    After the approval of a majority of the members of the Commission.
(j)    Money expended from the Fund is supplemental to and is not intended to take the place of funding that would otherwise be appropriated for the Maryland Medical Assistance Program.
(k)    The Fund is subject to audit by the Office of Legislative Audits as provided in § 2–1220 of the State Government Article.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-211 - Jurisdiction of Commission

(a)    (1)    Except for a facility that is operated or is listed and certified by the First Church of Christ Scientist, Boston, Massachusetts, the Commission has jurisdiction over hospital services offered by or through all facilities.
(2)    The jurisdiction of the Commission over any identified physician service shall terminate for a facility on the request of the facility.
(3)    The rate approved for an identified physician service may not exceed the rate on June 30, 1985, adjusted by an appropriate index of inflation.
(b)    The Commission may not set rates for related institutions until:
(1)    State law authorizes the State Medical Assistance Program to reimburse related institutions at Commission rates; and
(2)    The United States Department of Health and Human Services agrees to accept Commission rates as a method of providing federal financial participation in the State Medical Assistance Program.
(c)    The Commission shall set rates for hospital services provided at:
(1)    A freestanding medical facility pilot project authorized under Subtitle 3A of this title prior to January 1, 2008; and
(2)    A freestanding medical facility licensed under Subtitle 3A of this title.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-212 - Financial Status

The Commission shall:
(1)    Require each facility to disclose publicly:
(i)    Its financial position; and
(ii)    As computed by methods that the Commission determines, the verified total costs incurred and revenue generated by the facility in providing health services;
(2)    Review for reasonableness and certify the rates and revenue of each facility;
(3)    Keep informed as to whether a facility has enough resources to meet its financial requirements;
(4)    Concern itself with solutions if a facility does not have enough resources;
(5)    Assure each purchaser of health care facility services that:
(i)    The total costs of all hospital services offered by or through a facility are reasonable;
(ii)    The aggregate rates of the facility are related reasonably to the aggregate costs of the facility; and
(iii)    Rates are set equitably among all purchasers of services without undue discrimination;
(6)    Develop guidelines for the establishment of global budgets for each facility under Maryland’s all–payer model contract, including guidelines to prevent facilities from taking actions to meet a budget that the Commission determines would have adverse consequences for recipients or purchasers of services;
(7)    Receive confirmation from Commission staff that facility global budget agreements, as they are developed, are consistent with the guidelines; and
(8)    After review by the Commission for compliance with the guidelines, post each executed global budget agreement on the Commission’s website.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-214 - Hospital Uncompensated Care and Disproportionate Share Hospital Payment

(a)    The Commission shall assess the underlying causes of hospital uncompensated care and make recommendations to the General Assembly on the most appropriate alternatives to:
(1)    Reduce uncompensated care; and
(2)    Assure the integrity of the payment system.
(b)    The Commission may adopt regulations establishing alternative methods for financing the reasonable total costs of hospital uncompensated care and the disproportionate share hospital payment provided that the alternative methods:
(1)    Are in the public interest;
(2)    Will equitably distribute the reasonable costs of uncompensated care and the disproportionate share hospital payment;
(3)    Will fairly determine the cost of reasonable uncompensated care and the disproportionate share hospital payment included in hospital rates;
(4)    Will continue incentives for hospitals to adopt fair, efficient, and effective credit and collection policies; and
(5)    Will not result in significantly increasing costs to Medicare or termination of the all–payer model contract.
(c)    Any funds generated through hospital rates under an alternative method adopted by the Commission in accordance with subsection (b) of this section may only be used to finance the delivery of hospital uncompensated care and the disproportionate share hospital payment.
(d)    (1)    Each year, the Commission shall assess a uniform, broad–based, and reasonable amount in hospital rates to reflect the aggregate reduction in hospital uncompensated care realized from the expansion of health care coverage under Chapter 7 of the Acts of the 2007 Special Session of the General Assembly.
(2)    (i)    1.    The Commission shall ensure that the assessment amount equals 1.25% of projected regulated net patient revenue.
2.    Each hospital shall remit its assessment amount to the Health Care Coverage Fund established under § 15–701 of this article.
(ii)    Any savings realized in averted uncompensated care as a result of the expansion of health care coverage under Chapter 7 of the Acts of the 2007 Special Session of the General Assembly that are not subject to the assessment under paragraph (1) of this subsection shall be shared among purchasers of hospital services in a manner that the Commission determines is most equitable.
(3)    (i)    Funds generated from the assessment under this subsection may be used only to supplement coverage under the Medical Assistance Program beyond the eligibility requirements in existence on January 1, 2008.
(ii)    Any funds remaining after the expenditure of funds under subparagraph (i) of this paragraph has been made may be used for the general operations of the Medicaid program.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-214.4 - Medical Bill Reimbursement for Hospital Services -- Financial Assistance. [Effective Until June 30, 2025]

// EFFECTIVE UNTIL JUNE 30, 2025 PER CHAPTER 683 OF 2022 //
(a)    The Commission, in coordination with the Department of Human Services, the State designated exchange, the Office of the Comptroller, and the Maryland Hospital Association, shall develop a process that:
(1)    Identifies the patients who paid for hospital services who may have qualified for free care under § 19–214.1 of this subtitle at the time of care during calendar years 2017 through 2021;
(2)    Provides reimbursement to the patients identified under item (1) of this subsection, which may be applied incrementally;
(3)    Ensures that a patient’s alternate address is used if the patient requested an alternate address for safety reasons; and
(4)    Determines how the Commission, the Department of Human Services, and the Office of the Comptroller should share with or disclose relevant information, including tax information, to the minimum extent necessary, to the hospital and in accordance with federal and State confidentiality laws for the purpose of carrying out the process developed under this subsection.
(b)    The Commission may modify the process developed under subsection (a) of this section as necessary.
(c)    (1)    On or before January 1, 2023, and January 1, 2024, the Commission shall report to the Senate Finance Committee and the House Health and Government Operations Committee, in accordance with § 2–1257 of the State Government Article, on the development and implementation by hospitals of the process required under subsection (a) of this section.
(2)    If the process developed under subsection (a) of this section requires legislation for implementation, the Commission shall include the legislative recommendations in the report required on or before January 1, 2023, under paragraph (1) of this subsection.
(3)    If the process established under subsection (a) of this section does not require legislation, each hospital shall implement the process developed under subsection (a) of this section on or before January 1, 2023.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-215 - Uniform Accounting and Financial Reporting System

(a)    (1)    After public hearings and consultation with any appropriate advisory committee, the Commission shall adopt, by rule or regulation, a uniform accounting and financial reporting system that:
(i)    Includes any cost allocation method that the Commission determines; and
(ii)    Requires each facility to record its income, revenues, assets, expenses, outlays, liabilities, and units of service.
(2)    Each facility shall adopt the uniform accounting and financial reporting system.
(b)    In conformity with this subtitle, the Commission may allow and provide for modifications in the uniform accounting and financial reporting system to reflect correctly any differences among facilities in their type, size, financial structure, or scope or type of service.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-216 - Required Reports of Facilities

(a)    At the end of the fiscal year for a facility, at least 120 days following a merger or a consolidation, and at any other interval that the Commission sets, the facility shall file:
(1)    A balance sheet that details its assets, liabilities, and net worth;
(2)    A statement of income and expenses;
(3)    The most recent Form 990 that the facility filed with the Internal Revenue Service; and
(4)    Any other report that the Commission requires about costs incurred in providing services.
(b)    (1)    A report under this section shall:
(i)    Be in the form that the Commission requires;
(ii)    Conform to the uniform accounting and financial reporting system adopted under this subtitle; and
(iii)    Be certified by the facility’s certified public accountant.
(2)    If the Commission requires, responsible officials of a facility also shall attest that, to the best of their knowledge and belief, the report has been prepared in conformity with the uniform accounting and financial reporting system adopted under § 19–211 of this subtitle.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-217 - Notification of Certain Financial Transactions, Contracts or Agreements Required

(a)    Except as provided in subsection (c) of this section, a facility shall notify the Commission at least 30 days prior to executing any financial transaction, contract, or other agreement that would:
(1)    Pledge more than 50% of the operating assets of the facility as collateral for a loan or other obligation;
(2)    Result in more than 50% of the operating assets of the facility being sold, leased, or transferred to another person or entity; or
(3)    Result in more than 50% of all corporate voting rights or governance reserve powers being transferred to or assumed by another person or entity.
(b)    Except as provided in subsection (c) of this section, the Commission shall publish a notice of the proposed financial transaction, contract, or other agreement reported by a facility in accordance with subsection (a) of this section in a newspaper of general circulation in the area where the facility is located.
(c)    The provisions of this section do not apply to any financial transaction, contract, or other agreement made by a facility with any issuer of tax–exempt bonds, including the Maryland Health and Higher Education Facilities Authority, the State, or any county or municipal corporation of the State, if a notice of the proposed issuance of revenue bonds that meets the requirements of § 147(f) of the Internal Revenue Code has been published.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-218 - Additional Information

(a)    The Commission shall require each facility to give the Commission information that:
(1)    Concerns the total financial needs of the facility;
(2)    Concerns its current and expected resources to meet its total financial needs;
(3)    Includes the effect of any proposal made, under Subtitle 1 of this title, on comprehensive health planning; and
(4)    Includes physician information sufficient to identify practice patterns of individual physicians across all facilities.
(b)    The identities of individual physicians are confidential and are not discoverable or admissible in evidence in a civil or criminal proceeding, and may only be disclosed to the following:
(1)    The utilization review committee of a Maryland hospital;
(2)    The Medical and Chirurgical Faculty of the State of Maryland;
(3)    The State Board of Physicians;
(4)    The Office of Health Care Quality in the Department;
(5)    The Maryland Health Care Commission; or
(6)    An investigatory body under the State or federal government.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-220 - Rate Review and Approval Procedures

(a)    (1)    To have the statistical information needed for rate review and approval, the Commission shall compile all relevant financial and accounting information.
(2)    The information shall include:
(i)    Necessary operating expenses;
(ii)    Appropriate expenses that are incurred in providing services to patients who cannot or do not pay;
(iii)    Incurred interest charges; and
(iv)    Reasonable depreciation expenses that are based on the expected useful life of property or equipment.
(b)    The Commission shall define, by regulation, the types and classes of charges that may not be changed, except as specified in § 19-222 of this subtitle.
(c)    The Commission shall obtain from each facility its current rate schedule and each later change in the schedule that the Commission requires.
(d)    Consistent with the all–payer model contract approved by the federal Center for Medicare and Medicaid Innovation, the Commission shall:
(1)    Permit a nonprofit facility to charge reasonable rates that will permit the facility to provide, on a solvent basis, effective and efficient service that is in the public interest; and
(2)    Permit a proprietary profit–making facility to charge reasonable rates that:
(i)    Will permit the facility to provide effective and efficient service that is in the public interest; and
(ii)    Based on the fair value of the property and investments that are related directly to the facility, include enough allowance for and provide a fair return to the owner of the facility.
(e)    In the determination of reasonable rates for each facility, as specified in this section, the Commission shall take into account all of the cost of complying with recommendations made, under Subtitle 1 of this title, on comprehensive health planning.
(f)    In reviewing rates or charges or considering a request for change in rates or charges, the Commission shall permit a facility to charge rates that, in the aggregate, will produce enough total revenue to enable the facility to meet reasonably each requirement specified in this section.
(g)    Except as otherwise provided by law, in reviewing rates or charges or considering a request for changes in rates or charges, the Commission may not hold executive sessions.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-223 - Fee for Closed or Delicensed Hospitals

The Commission shall assess a fee on all hospitals whose rates have been approved by the Commission to pay for:
(1)    To the extent provided for in Title 10, Subtitle 3, Part IV of the Economic Development Article, the amounts required by § 10–350 of the Economic Development Article with respect to public obligations or closure costs of a closed or delicensed hospital; and
(2)    Funding the Hospital Employees Retraining Fund.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-224 - Report of Transactions With Nonprofit Facility by Trustee, Director, or Officer

(a)    This section applies to each person that is concurrently:
(1)    A trustee, director, or officer of any nonprofit facility in this State; and
(2)    An employee, partner, director, officer, or beneficial owner of 3 percent or more of the capital account or stock of:
(i)    A partnership;
(ii)    A firm;
(iii)    A corporation; or
(iv)    Any other business entity.
(b)    Each person specified in subsection (a) of this section shall file with the Commission an annual report that discloses, in detail, each business transaction between any business entity specified in subsection (a)(2) of this section and any facility that the person serves as specified in subsection (a)(1) of this section, if any of the following is $10,000 or more a year:
(1)    The actual or imputed value or worth to the business entity of any transaction between it and the facility; or
(2)    The amount of the contract price, consideration, or other advances by the facility as part of the transaction.
(c)    A report under this section shall be:
(1)    Signed and verified; and
(2)    Filed in accordance with the procedures and on the form that the Commission requires.
(d)    A person that willfully fails to file any report required by this section is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $500.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-225 - Hearings and Investigations

(a)    In any matter that relates to a facility’s cost of services and consistent with the all–payer model contract, the Commission may:
(1)    Hold a public hearing;
(2)    Conduct an investigation;
(3)    Require the filing of any information; or
(4)    Subpoena any witness or evidence.
(b)    The Executive Director of the Commission may administer oaths in connection with any hearing or investigation under this section.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-226 - Further Investigations

(a)    If the Commission considers a further investigation necessary or desirable to authenticate information in a report that a facility files under this subtitle, consistent with the all–payer model contract, the Commission may make any necessary further examination of the records or accounts of the facility, in accordance with the rules or regulations of the Commission.
(b)    The examination under this section may include a full or partial audit of the records or accounts of the facility that is:
(1)    Provided by the facility; or
(2)    Performed by:
(i)    The staff of the Commission;
(ii)    A third party for the Commission; or
(iii)    The Legislative Auditor.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 2 - Health Services Cost Review Commission › Part II - Health Care Facility Rate Setting › Section 19-227 - Appeals

(a)    (1)    Any person aggrieved by a final decision of the Commission under this subtitle may take a direct judicial appeal.
(2)    The appeal shall be made as provided for judicial review of final decisions in the Administrative Procedure Act.
(b)    (1)    An appeal from a final decision of the Commission under this section shall be taken in the name of the person aggrieved as appellant and against the Commission as appellee.
(2)    The Commission is a necessary party to an appeal at all levels of the appeal.
(3)    The Commission may appeal any decision that affects any of its final decisions to a higher level for further review.
(4)    On grant of leave by the appropriate court, any aggrieved party or interested person may intervene or participate in an appeal at any level.
(c)    Any person, government agency, or nonprofit health service plan that contracts with or pays a facility for health care services has standing to participate in Commission hearings and shall be allowed to appeal final decisions of the Commission.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 3 - Hospitals and Related Institutions › Part I - Definitions; General Provisions › Section 19-302 - Scope of Subtitle

(a)    This subtitle does not apply to a dispensary or first aid treatment facility that is maintained only to provide services for:
(1)    Employees of a commercial or industrial plant;
(2)    Employees or students of an educational institution; or
(3)    Individuals in a convent, county home, motel, hotel, apartment, or facility, if the individuals are able to live independently.
(b)    This subtitle applies to the provision of home health care services by a hospital or related institution to 2 or more unrelated individuals, whether the services are provided directly or under contract with a home health agency.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 3 - Hospitals and Related Institutions › Part I - Definitions; General Provisions › Section 19-304 - Reporting Unexpected Occurrences or Incidents; Analysis

(a)    A hospital or related institution shall:
(1)    Report an unexpected occurrence related to an individual’s medical treatment that results in death or serious disability that is not related to the natural course of the individual’s illness or underlying disease condition; and
(2)    Submit the report to the Department within 5 days of the hospital’s or related institution’s knowledge of the occurrence.
(b)    A hospital or related institution may report to the Department an unexpected occurrence or other incident related to an individual’s medical treatment that does not result in death or serious disability.
(c)    A hospital or related institution shall:
(1)    Conduct a root cause analysis of an occurrence required to be reported under subsection (a) of this section; and
(2)    Unless the Department approves a longer time period, submit the root cause analysis to the Department within 60 days of the hospital’s or related institution’s knowledge of the occurrence.
(d)    If a hospital or related institution fails to comply with subsection (a) or (c) of this section, the Secretary may impose a fine of $500 per day for each day the violation continues.
(e)    The Secretary shall adopt regulations to implement this section.
2023 Maryland Statutes › Health - General › Title 19 - Health Care Facilities › Subtitle 3 - Hospitals and Related Institutions › Part I - Definitions; General Provisions › Section 19-305 - Notification of Change in Condition or Adverse Event by Residential Treatment Centers

(a)    (1)    In this section the following words have the meanings indicated.
(2)    “Adverse event” means an unexpected occurrence that:
(i)    Is related to a resident’s medical or behavioral treatment; and
(ii)    Is not related to the natural course of the resident’s illness or underlying disease condition.
(3)    “Change in condition” means a significant change in a resident’s physical, mental, or psychological status including:
(i)    Life-threatening conditions;
(ii)    Clinical complications including significant somatic symptoms that require the assessment of or treatment by qualified medical personnel;
(iii)    The need to discontinue a medication or treatment because of:
1.    Adverse consequences; or
2.    The need to begin a new form of treatment;
(iv)    Evaluation at or admission to a hospital;
(v)    Injuries that require the assessment of or treatment by qualified medical personnel;
(vi)    The use of restraint or seclusion; and
(vii)    Suicide attempts.
(b)    (1)    Within 24 hours, in accordance with State and federal confidentiality laws, a residential treatment center shall attempt to notify a resident and a resident’s representative, family member, legal guardian, or custodian of:
(i)    A change in condition;
(ii)    An adverse event; and
(iii)    Corrective action, if appropriate.
(2)    If a residential treatment center sends a notice to an individual under paragraph (1) of this subsection, the individual may send a written response to the residential treatment center instructing the residential treatment center that:
(i)    The individual waives the notification required under paragraph (1) of this subsection; or
(ii)    The individual requires notification only in the circumstances specified in writing by the individual.
(c)    A residential treatment center shall document the notification required under subsection (b)(1) of this section and the response of the resident and the resident’s representative, family member, legal guardian, or custodian in the resident’s medical record.
(d)    If the Department determines that a residential treatment center failed to notify a resident and a resident’s representative, family member, legal guardian, or custodian under subsection (b)(1) of this section, the Department shall require the residential treatment center, as part of a plan of correction, to notify the resident and the resident’s representative, family member, legal guardian, or custodian as soon as possible.