Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 2 › Subtitle 09 - MEDICAL CARE PROGRAMS › Chapter 10.09.47 - Disproportionate Share Hospitals › Section 10.09.47.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In addition to
				  the definitions contained in §B of this regulation, definitions set forth
				  in COMAR 10.09.06.01D are
				  applicable to this chapter.
B.
				  Terms Defined.
(1) "Charity care" means
				  hospital care for which the costs are not reimbursed through any patient or
				  third party.
(2) "Charity care
				  inpatient costs" means hospital costs that are not reimbursed through any
				  patient or third party, reduced by the amount of gifts, restricted grants, or
				  income from endowments. For the purposes of this chapter, third party payments
				  include Medicaid payments for the cost of care, but do not include
				  disproportionate share payments.
(3) "Low-income hospital costs" means the sum
				  of a hospital's:
(a) Inpatient Medicaid
				  costs;
(b) State and local
				  government inpatient cash subsidies; and
(c) Charity care inpatient costs.
(4) "Low-income utilization rate"
				  means, for a hospital, the sum of:
(a) A
				  fraction, expressed as a percentage:
(i) The
				  numerator of which is the sum, for a fiscal year, of the total revenues paid
				  the hospital for patient services under a Medical Assistance Program, and the
				  amount of cash subsidies for patient services received directly from State and
				  local governments, and
(ii) The
				  denominator of which is the total amount of revenues of the hospital for
				  patient services, including the amount of the cash subsidies in the fiscal
				  year; and
(b) A
				  fraction, expressed as a percentage:
(i) The
				  numerator of which is the total amount of the hospital's charges for inpatient
				  hospital services that are attributable to charity care in a fiscal year, less
				  the portion of any cash subsidies described in §B(4)(a)(i) of this
				  regulation in the period reasonably attributable to inpatient hospital
				  services, and
(ii) The denominator
				  of which is the total amount of the hospital's charges for inpatient hospital
				  services in the hospital in the period reasonably attributable to inpatient
				  hospital services.
(5) "Medicaid cost" means an amount equal to
				  Medicaid payments by the Medicaid program.
(6) "Medicaid inpatient utilization rate"
				  means a fraction, expressed as a percentage:
(a) The numerator of which is the hospital's
				  number of inpatient days attributable to patients who were eligible for Medical
				  Assistance benefits under Title XIX of the Social Security Act for a fiscal
				  year; and
(b) The denominator of
				  which is the total number of the hospital's inpatient days for the fiscal year
				  in §B(6)(a) of this regulation.
(7) "State and local government inpatient
				  cash subsidies" means the payments for hospital costs from State or local
				  government health agencies that are not intended as reimbursement for costs
				  directly associated with particular patients, but are provided more generally
				  for operating costs of the institution. These subsidies do not include Medicaid
				  payments or disproportionate share payments.