reglab/statecodes huggingface dataset:
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.02 - Attendance

Current through Register Vol. 51, No. 14, July 12, 2024
A quorum need not be present in order for the Commission to
					 hold a public meeting. If, however, less than a quorum is present at any public
					 meeting, matters submitted for a vote shall be deferred.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.03 - Presiding Officer

Current through Register Vol. 51, No. 14, July 12, 2024
The Chairman, or in his absence, the Vice-Chairman of the
					 Commission or a designee shall preside at public meetings which may be called
					 to order when the above presiding officer or his designee is in attendance. The
					 Commission shall transact routine business and shall sit for the consideration
					 of any and all matters which may properly be brought before it at the
					 meeting.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.04 - Agenda

Current through Register Vol. 51, No. 14, July 12, 2024
The Executive Director of the Commission in consultation
					 with the Chairman shall be responsible for developing the agenda for each
					 public meeting.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.05 - Records

Current through Register Vol. 51, No. 14, July 12, 2024
Minutes of the meeting shall be taken by the Commission and
					 made available for public inspection at the offices of the Commission, during
					 ordinary business hours.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.06 - Voting

Current through Register Vol. 51, No. 14, July 12, 2024
A. Each Commission
				  member, except the Chairman, shall be entitled to one vote on each matter
				  submitted to a vote at the meeting.
B. Voting shall be in person or by
				  proxy.
C. The Chairman shall vote
				  only to break a tie or cast a fourth concurring vote.
D. During the time between public meetings,
				  each Commission member shall be entitled to one vote on each matter submitted
				  to vote.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.08 - Conduct of Public Meetings › Section 10.37.08.07 - Adjournment

Current through Register Vol. 51, No. 14, July 12, 2024
A public meeting may be adjourned by a majority of those
					 Commission members present in person.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.09 - Fee Assessment for Financing Hospital Uncompensated Care › Section 10.37.09.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In this chapter,
				  the following terms have the meanings indicated.
B. Terms Defined.
(1) "Automated clearing house (ACH)", as
				  defined in COMAR
				  03.01.02.01B,
				  means a central clearing organization that operates as a clearing house for
				  transmitting or receiving entries between banks and bank accounts, and
				  authorizes an electronic transfer of funds between banks or bank
				  accounts.
(2) "Commission" means
				  the Health Services Cost Review Commission.
(3) "Comptroller" means the Comptroller of
				  the Treasury or the Comptroller's designee.
(4) "General Accounting Division" means the
				  Fiscal Services Administration for the Department of Health and Mental
				  Hygiene.
(5) "Health Services Cost
				  Review Commission Fund" means the special fund established under Health-General
				  Article, §19-207.1(d), Annotated Code of Maryland.
(6) "Hospital" means an institution that is
				  licensed by the Department of Health and Mental Hygiene as an acute general
				  hospital.
(7) "Hospital
				  Uncompensated Care Fund" means the monies that are collected from hospitals for
				  the equitable financing of hospital uncompensated care and which are a discrete
				  part of the Health Services Cost Review Commission Fund.
(8) "Interest" means the investment earnings
				  generated from the investment and reinvestment of the monies of the Hospital
				  Uncompensated Care Fund which are separately held by the Treasury, accounted
				  for by the Comptroller, and retained to the credit of the Health Services Cost
				  Review Commission Fund.
(9)
				  "Mark-up" means the mechanism used to increase hospital rates to allow for
				  payer differentials, working capital (prompt payment) differentials, and a
				  provision for uncompensated care.
(10) "Remittance" means the amount each
				  hospital remits to the General Accounting Division pursuant to the
				  predetermined formula established by the Commission to provide funding for the
				  Commission's Hospital Uncompensated Care Fund.
(11) "Special rate adjustment" means an
				  adjustment to a hospital's rates, which will bring the hospital's uncompensated
				  care provision of its mark-up to the Statewide uncompensated care
				  average.
(12) "Treasury" means the
				  State Treasury.
(13) "Wire
				  transfer" means an electronic transaction in which a hospital, through the
				  hospital's bank and an automated clearing house, originates an entry crediting
				  the Health Services Cost Review Commission Fund's bank account and debiting the
				  hospital's bank account on the same day the transaction is initiated.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.09 - Fee Assessment for Financing Hospital Uncompensated Care › Section 10.37.09.02 - Special Rate Adjustment and Collection

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Commission shall make a special rate
				  adjustment to the uncompensated care provision of each hospital's mark-up to
				  pay for the financing of the reasonable costs of hospital uncompensated care.
				  The Commission shall notify hospitals in writing of the amount due to be
				  remitted in a given month before the first day of that month.
B. On or before the first business day of
				  each month, the Commission shall direct the General Accounting Division to
				  arrange for the collection of the amount due to be remitted by individual
				  hospitals. This amount shall be based on the difference between a hospital's
				  uncompensated care provision in its mark-up and the Statewide uncompensated
				  care average.
C. The Commission
				  shall, at the same time, notify the General Accounting Division in writing of
				  the:
(1) Hospitals due to remit for that
				  month;
(2) Amount of the remittance
				  for that month;
(3) Hospitals to
				  receive payments from the Hospital Uncompensated Care Fund for that
				  month;
(4) Amount to be disbursed
				  to hospitals from the Hospital Uncompensated Care Fund in that month;
				  and
(5) The appropriate banking
				  account information from each hospital in order to debit or disburse funds
				  electronically by wire transfer.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.09 - Fee Assessment for Financing Hospital Uncompensated Care › Section 10.37.09.03 - Payment of Remittance Due

Current through Register Vol. 51, No. 14, July 12, 2024
A. By
				  January 1, 2009, each hospital shall provide the Commission with sufficient
				  banking information to facilitate the collection and disbursement of funds by
				  the ACH or other wire transfer method. Each hospital shall initiate or
				  authorize the ACH or other wire transfer method as directed by the
				  Commission.
B. On or before the 5th
				  business day of each month, each hospital identified as due to remit monies in
				  accordance with the provisions of these regulations shall make payment into the
				  Hospital Uncompensated Care Fund in the manner prescribed by the
				  Commission.
C. On or before the 5th
				  business day of each month, the Comptroller shall transfer monies out of the
				  Hospital Uncompensated Care Fund and distribute monies to hospitals in the
				  manner specified by the Commission.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.09 - Fee Assessment for Financing Hospital Uncompensated Care › Section 10.37.09.04 - Use of Funds

Current through Register Vol. 51, No. 14, July 12, 2024
A. Funds
				  generated through the special rate adjustment and the remittance due may only
				  be used to finance the delivery of hospital uncompensated care.
B. Interest earned from the monies collected
				  shall be retained to the credit of the Hospital Uncompensated Care
				  Fund.
C. Interest earned may be
				  used to pay for the reasonable expenses associated with implementation of the
				  alternative methodology approved by the Commission for financing the reasonable
				  costs of hospital uncompensated care.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.09 - Fee Assessment for Financing Hospital Uncompensated Care › Section 10.37.09.06 - Failures or Delay in Paying Remittance/Penalties

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Commission may impose penalties of up
				  to 5 percent of the amount of an underpayment, unless an extension is granted
				  as provided in §E of this regulation.
B. A hospital that violates the provisions of
				  Regulation .03 of this chapter shall, in addition to the penalties imposed
				  under §A of this regulation, be subject to an annualized interest charge
				  of 3 percentage points above the most recent average prime rate of interest, as
				  published in the "Money Rates" section of the The Wall Street Journal, on the
				  unpaid balance.
C. In addition to
				  the penalties the Commission may impose on a hospital that fails to pay the
				  remittance in a timely manner, the Commission may refer the hospital's
				  delinquent account to the Department of Budget and Fiscal Planning's Central
				  Collection Unit pursuant to the procedures in State Finance and Procurement
				  Article, Title 3, Subtitle 3, Annotated Code of Maryland.
D. A hospital may file a written request with
				  the Commission for a reasonable extension of time to make payment if the
				  extension request is:
(1) Made in writing to
				  the attention of the Executive Director;
(2) Supported by sufficient justification;
				  and
(3) Made at a reasonable time
				  before the due date of a required payment.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.01 - Definitions

Current through Register Vol. 51, No. 14, July 12, 2024
A. "Burden of
				  proof" means the burden of persuasion by the preponderance of the
				  evidence.
B. "Commission" means the
				  Health Services Cost Review Commission.
C. "Executive Director" means the Executive
				  Director of the Commission, or in his absence, the Commission staff member
				  designated to act in his stead.
D.
				  "Opinion" means a written statement setting forth the reasons and grounds why
				  the writer of the statement believes that certain actions should be taken or
				  decisions or recommendations made.
E. "Order Nisi" means an order of the
				  Commission that certain actions shall be taken or that certain matters are
				  approved as of a future date, thereby permitting parties affected by the Order
				  Nisi to make any objections they may have known to the Commission.
F. Partial Rate Application.
(1) "Partial rate application" means a
				  request by a hospital for the amendment or establishment of a single approved
				  rate.
(2) "Partial rate
				  application" includes, but is not limited to, those requests enumerated in
				  Regulation .03B(4) of this chapter.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.01-1 - Incorporation by Reference

Current through Register Vol. 51, No. 14, July 12, 2024
The Alternative Rate Setting Method (ARM) Manual (1998) is
					 hereby incorporated by reference.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.02 - Rate Review System

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  rate review system, otherwise known as the Accounting and Budget Manual for
				  Fiscal and Operating Management, shall consist of:
(1) The rate review forms; and
(2) Instructions for completion of the
				  forms.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.03 - Regular Rate Applications

Current through Register Vol. 51, No. 14, July 12, 2024
A. A hospital
				  may not file a full rate application with the Commission until the Commission
				  staff is able to determine through analysis that the data used to evaluate a
				  full rate application has not been substantially affected by the COVID
				  pandemic. During this interim period, a hospital may seek a rate adjustment
				  under any other administrative remedy available to it under existing Commission
				  law, regulation, or policy. In no event shall this moratorium continue in
				  effect beyond June 30, 2023. Once the moratorium is lifted, a hospital may file
				  a regular rate application at any time if:
(1) The rates being requested are not the
				  subject of a hospital-instituted case pending before the Commission;
				  or
(2) The subject hospital has not
				  obtained permanent rates through the issuance of a Commission rate order within
				  the previous 365 days.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.03-1 - Partial Rate Application

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  The provisions of Regulation .03B(2) of this chapter may be waived by staff in
				  the review of a partial rate application.
B. A hospital may file a partial rate
				  application with the Commission at any time, consistent with the provisions of
				  Regulation .03A of this chapter. A partial rate application is not a contested
				  case under the provisions of the Administrative Procedure Act.
C. The Commission shall act on a docketed
				  partial rate application within the time frames established for a full rate
				  application that does not involve a public hearing, consistent with Commission
				  law and regulation.
D. A hospital
				  that has been denied its request for a partial rate change may file a full rate
				  application with the Commission in accordance with Commission law and
				  regulation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.04 - Commission Review of Established Rates

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Commission may order a review of a hospital's established rates at any time, as
				  it deems necessary and proper.
B.
				  This order, provided it orders the review of any rate or charge, may constitute
				  a Commission-initiated rate proceeding.
C. In reviewing a hospital's established
				  rates during a Commission-initiated rate proceeding or while reviewing a
				  hospital's full rate application, the Commission shall consider the hospital's
				  performance since the implementation of the All-Payer Model Agreement with the
				  federal government, which took place in February 2014.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.04-2 - Global Budget Revenue Methodology

Current through Register Vol. 51, No. 14, July 12, 2024
A. The Global Budget Revenue (GBR)
				  methodology implemented by the Commission effective January 1, 2014,
				  establishes reasonable revenue levels for Maryland's general acute hospitals,
				  which will enable them to improve quality and efficiency on a solvent basis
				  within the constraints imposed by the All-Payer Model.
B. In setting reasonable revenue levels, the
				  Commission shall take into account a number of factors. These may include, but
				  are not limited to the following:
(1) The
				  casemix severity and reasonable utilization of the hospital's
				  patients;
(2) The historical
				  charges of the hospital;
(3) The
				  statutory requirement regarding the reasonable relationship between costs and
				  charges;
(4) The hospital's payer
				  man,
(5) The reasonable
				  uncompensated care requirements of the hospital;
(6) The reasonable Graduate Medical Education
				  (GME) costs of the hospital as determined by the Commission;
(7) Appropriate
				  adjustments, if any, associated with exceptional or outlier cases as defined by
				  the Commission;
(8) Wage levels at
				  the hospital and at other hospitals in the geographic area of the hospital and
				  elsewhere in Maryland;
(9)
				  Adjustments for quality improvement and value-based payment programs applicable
				  to the hospital;
(10) Reasonable
				  infrastructure funding for care management and care coordination for hospital
				  patients;
(11) The annual update factor;
(12)
				  The proportion of unnecessary care, including Potentially Avoidable Utilization
				  (PAU) at the hospital; and
(13) The
				  performance of the State as a whole under the All-Payer Model.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.04-3 - Global Budget Revenue Mechanism

Current through Register Vol. 51, No. 14, July 12, 2024
A. For purposes of this regulation, the
				  following definitions apply:
(1) "Annual
				  update factor" means the amount by which total State hospital revenue may
				  increase in a rate year.
(2)
				  "Demographic adjustment" means the percentage increase in allowed revenue
				  related to changes in population and the age/sex mix of the population residing
				  in the hospital's primary service area, net of any reductions.
(3) "Factor cost inflation" means increases
				  in the costs of goods, services, wages, and salaries experienced by the
				  hospitals as calculated by the Commission for the most recent period for which
				  data are available preceding the year for which the Commission calculates case
				  target updates.
(4) "Hospital
				  update" means the amount by which an individual hospital's approved GBR revenue
				  changes in a particular rate year (i.e., July 1 -June 30).
(5) "Market shift adjustment" means the rate
				  adjustment applied by the Commission, which increases or decreases the approved
				  GBR revenue of a hospital to reflect changes in volume at the hospital for
				  which there was a corresponding change in volume at another Maryland hospital
				  or other provider.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.05 - Application for Temporary Change in Rates

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Commission may issue a general notice setting forth circumstances under which a
				  hospital may obtain a temporary change in rates. The rates, if approved or
				  modified, shall be effective before the rate review procedure set forth in
				  these regulations, but not before the date of application.
B. A hospital may apply at any time for a
				  temporary change in rates provided that one of the following conditions is
				  satisfied:
(1) A decline in the hospital's
				  experienced or projected net revenues, due to factors beyond the hospital's
				  control, requiring funds beyond those normally available;
(2) An increase in the hospital's experienced
				  or projected expenses, due to factors beyond the hospital's control, requiring
				  funds beyond those normally available; or
(3) A hospital's expenses from regulated
				  services exceed its revenues from regulated services, or the hospital's
				  financial integrity is otherwise jeopardized (for example, for breaching its
				  bond covenants).
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.06 - Application for Alternative Method of Rate Determination

Current through Register Vol. 51, No. 14, July 12, 2024
A. At any time on or after July 1, 1974, a
				  hospital may file a written application with the Commission requesting an
				  alternative method for submitting or reviewing any or all of its rates and
				  charges, specifying the reasons for and details of the alternative
				  methods.
B. If warranted by the
				  circumstances set forth in the application, the Executive Director may grant a
				  temporary approval of an alternative method of rate determination.
C. The procedure for submitting and reviewing
				  an application under an alternative method of rate determination shall follow
				  as closely as possible the procedure for a regular rate application, except
				  that the time periods and limitations set forth in these regulations do not
				  apply to an application for an alternative method of rate
				  determination.
D. At anytime after
				  the approval of an alternative method of rate review by the Executive Director,
				  the Commission may initiate further proceedings to determine the hospital's
				  continuing qualification for the alternative method of rate
				  determination.
E. ARM System.
(1) The Commission may implement a system
				  providing for alternative rate setting methods (ARM) which would permit
				  hospitals to accept financial risk for the provision of hospital services under
				  certain conditions and circumstances.
(2) The implementation of an ARM system shall
				  be consistent with the principles of equity and access embodied in the
				  Commission's all-payer rate setting system.
(3) The ARM Manual shall set forth the
				  process and requirements associated with the ARM system.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.07 - Rate Applications by New Hospitals or Existing Hospitals with Expanded Facilities or New Revenue Centers

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  At least 60 days before the operational opening of a new hospital, a revenue
				  center, or a new service within a hospital whose projected annual operating
				  cost exceeds $100,000, the hospital shall file a rate application for the
				  requested rates. This application shall be supported by financial data
				  presented in the format of the Commission's rate review system.
B. If an existing hospital expends its
				  operations so that the number of in-patient beds is increased by 20 percent or
				  more, and if a rate application is filed pertaining to the expended facilities
				  and providing for an occupancy rate for the expanded facilities of the hospital
				  at an amount below the target occupancy established by the Commission, the
				  Commission may require the filing of additional information projecting the
				  hospital's expanded facilities' activity levels for the first 5 years of their
				  operation.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.07-1 - Outpatient Services-At the Hospital Determination

Current through Register Vol. 51, No. 14, July 12, 2024
A. Definitions.
(1) In this regulation, the following terms
				  have the meanings indicated.
(2)
				  Terms Defined.
(a) "At the hospital" means a
				  service provided in a building on the campus of a hospital in which hospital
				  services are provided.
(b) "Health
				  care provider" means an individual who is licensed, certified, or otherwise
				  authorized by law to provide health care services under Health Occupations
				  Article, Annotated Code of Maryland.
(c) "Telehealth services" means the delivery
				  of health care services provided through the use of interactive audio, video,
				  or other telecommunications or electronic technology by a health care provider
				  at a hospital to a patient at a location other than at the hospital, which
				  enables the patient to interact with the health care provider at the time the
				  health care services are provided.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.07-2 - Outpatient Services - Freestanding Medical Facility

Current through Register Vol. 51, No. 14, July 12, 2024
A. Definition. In this regulation,
				  "freestanding medical facility" means a freestanding medical facility licensed
				  under Health-General Article, Title 19, Subtitle 3A, Annotated Code of
				  Maryland.
B. The following
				  outpatient services provided at a freestanding medical facility are considered
				  hospital services under Health-General Article, §19-201, Annotated Code of
				  Maryland:
(1) Emergency Services;
(2) Observation Services; and
(3) Associated Ancillary Services, such as
				  laboratory, radiology, imaging, EKG, and Medical/Surgical Supplies and
				  Drugs.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.08 - Content

Current through Register Vol. 51, No. 14, July 12, 2024
Each rate application shall include a list of services for
					 which new rates are being requested, a list of the present and requested rates,
					 and shall be based on the currently filed or required rate review
					 system.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.09 - Method of Filing

Current through Register Vol. 51, No. 14, July 12, 2024
The application may be filed by private messenger at the
					 Offices of the Commission, or may be filed by registered mail, return receipt
					 requested, at the following address:
Health Services Cost Review Commission
4160 Patterson Avenue
Baltimore, Maryland 21215
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.10 - Docketing and Receipt

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Docketing.
(1) When a valid rate application
				  is received, as per the above regulations, it shall be entered on the
				  Commission docket and a file opened.
(2) Each rate application shall be given an
				  annual docket number and a consecutive page number in the docket.
(3) Each rate application shall be given a
				  consecutive file number.
(4) A
				  regular rate application file number shall be noted "R".
(5) The file number of an order authorizing
				  Commission investigation and review of established rates shall be noted
				  "C".
(6) A temporary rate
				  application file number shall be noted "I".
(7) An alternative method of rate
				  determination application file number shall be noted "A".
(8) A rate application file number by a new
				  hospital or a hospital with expanded facilities or new revenue centers shall be
				  noted "N".
(9) The date of receipt
				  of the rate application shall be noted on the docket and on the file.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.11 - Recommendations of the Commission's Staff to the Commission, Options for Commission Review

Current through Register Vol. 51, No. 14, July 12, 2024
A. A rate
				  application review shall be completed and the recommendation given to the
				  Commission as soon as possible.
B.
				  The recommendation shall include a specification of those areas of costs which
				  the staff believes should be reviewed. When practicable, the recommendation
				  shall also include the amounts challenged by the staff.
C. Any of four actions may be recommended to
				  the Commission. If two or more actions are recommended, the issues and rates to
				  be evaluated in each action shall be set forth clearly. These four actions are
				  as follows:
(1) The Commission should hold a
				  public hearing on rates;
(2) The
				  Commission should grant tentative approval or modify all or some of the rates
				  and publish notice of an order nisi;
(3) The Commission should hold a general
				  hearing on rates;
(4) The
				  Commission should deny the application in which case it shall state the grounds
				  for the denial.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.12 - Preliminary Commission Order

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Commission shall consider the staff recommendation and, within 20 days of the
				  date of the recommendation, issue its preliminary order adopting or modifying
				  the recommendation, or referring the recommendations back to the staff for
				  further review and subsequent recommendations.
B. Order Nisi.
(1) If the Commission issues a preliminary
				  order granting tentative approval of any rates, it shall publish notice of the
				  order nisi and the rates.
(2) In
				  addition, the Commission shall forward copies of the order nisi and the rates
				  to the hospital and interested parties.
(3) The order nisi shall state:
(a) The name and address of the hospital; the
				  names of the designated interested parties; the docket, page, and file numbers
				  of the rate application proceeding and the date the application was filed with
				  the Commission.
(b) An enumeration
				  of services and the proposed representative rates to be charged:
(c) That the Commission has approved the
				  rates as of a date to be specified, with a provision that the order may be
				  suspended if reasonable cause is shown within 15 days of the date of the Order
				  Nisi.
(d) That objections to the
				  tentatively approved rates shall be submitted (in person or by mail) to the
				  Commission in writing; that designated interested parties shall submit copies
				  of their objections, identifying the proceeding and Order Nisi to which
				  objections are made to the hospital, and nine copies to the Commission office;
				  and
(e) That the file, which may
				  contain supporting documents from the hospital, the Commission staff
				  recommendation, the Accounting and Reporting reports and the Rate Review System
				  of the hospital, is available at the Commission offices during regular business
				  hours for public inspection.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.13 - Public Hearing Before the Commission

Current through Register Vol. 51, No. 14, July 12, 2024
A. Testimony shall be in writing and may not
				  be delivered orally, except as set forth in Regulation .14K, of this
				  chapter.
B. Presenting Direct
				  Testimony.
(1) Any person who wishes to
				  present direct testimony at the public hearing shall forward copies to the
				  hospital and to every designated interested party, and shall file nine copies
				  at the Commission's office.
(2) If
				  the public hearing is the result of a hospital rate application pursuant to
				  Regulation .03, of this chapter, the applicant shall file its testimony at
				  least 20 days before the date of the hearing. The staff of the Commission and
				  members of the public shall file their testimony at least 10 days before the
				  date of the hearing.
(3) If the
				  public hearing is the result of a Commission-initiated review of the rates of a
				  hospital pursuant to Regulation .04, of this chapter, the Commission staff
				  shall file its testimony at least 20 days before the date of the hearing. The
				  hospital and members of the public shall file their testimony at least 10 days
				  before the date of the hearing.
(4)
				  The designated interested parties shall file their testimony before the close
				  of the first hearing session.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.14 - Conduct of Public Hearing

Current through Register Vol. 51, No. 14, July 12, 2024
A. The
				  Chairman of the Commission shall preside at the public hearing, which may be
				  called to order when the presiding officer is in attendance. If the Chairman is
				  absent or has been disqualified, the Vice-chairman or another commissioner
				  shall preside.
B. The Commission
				  may direct that a hearing officer preside at the public hearing. In this case,
				  the hearing officer may exercise all powers given to a presiding commissioner
				  in these regulations during all sessions of the public hearing.
C. At the discretion of the Commission, the
				  specific duties of the hearing officer may include the following:
(1) Making all rulings as to evidence,
				  testimony, and official notice;
(2)
				  Setting the order for the examination and cross-examination of
				  witnesses;
(3) Administering oaths
				  and affirmations;
(4) Preparing
				  both written and oral summaries of cases heard;
(5) Preparing a recommendation for the
				  Commission consisting of a written report with findings of fact and conclusions
				  of law.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.16 - General Hearing Before the Commission

Current through Register Vol. 51, No. 14, July 12, 2024
A. To obtain general information from the
				  region and community in which a hospital is located, the Commission, at its
				  discretion, may hold a general hearing during the course of any rate
				  proceeding.
B. A general hearing
				  shall be supplementary to other methods of rate review and may not replace
				  them.
C. A general hearing shall be
				  held in the region in which the hospital whose rates are being reviewed is
				  located.
D. The public notice of a
				  general hearing may state:
(1) The name and
				  address of the hospital, the designated interested parties, the docket, page,
				  and file numbers of the application, and the time, date, and place of the
				  hearing;
(2) A description of the
				  issues to be considered at the general hearing;
(3) That any party interested in the matter
				  may attend and present written or oral statements concerning the announced
				  issues; and
(4) That presentations
				  may be limited as to time and that the number of spokespersons representing any
				  group or organization may be limited.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.18 - Format

Current through Register Vol. 51, No. 14, July 12, 2024
A. All pleadings,
				  motions, and other papers filed in a Commission proceeding shall be typed or
				  legibly written on sheets of bond paper not more than 11 inches long or 8-1/2
				  inches wide, and each paper shall have a left margin of at least 1 inch and a
				  top margin of at least 1-1/2 inches.
B. All pleadings, motions, and other papers,
				  excluding exhibits appended to the pleadings, shall contain a heading at the
				  top of the first page and, excluding appended exhibits and written direct
				  testimony for a public hearing, a certificate of service at the bottom of the
				  last page.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.19 - Filing of a Rate Application

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  A rate application filed by private messenger at the offices of the Commission
				  shall be deemed to be filed on the date the application is received during
				  normal working hours in the Commission's office.
B. A rate application sent by registered mail
				  shall be deemed to be filed 3 days after the application is placed in the U.S.
				  Postal Service, these days to exclude Saturdays, Sundays, and holidays on which
				  mail is not delivered to the Commission. The rate application's file date shall
				  be entered on the docket of the proceeding.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.20 - Service

Current through Register Vol. 51, No. 14, July 12, 2024
An original and three copies of all other pleadings,
					 documents, testimony, or motions to be considered by the Commission shall be
					 filed at the office of the Commission during regular business hours. All
					 pleadings, documents, testimony, or motions shall contain a certificate of
					 service indicating that the pleading, document, testimony, or motion has been
					 mailed or served upon all designated parties to that proceeding and upon the
					 Commission at its offices.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.21 - Computations of Time Periods and Extensions

Current through Register Vol. 51, No. 14, July 12, 2024
A. In computing any period of time prescribed
				  by these regulations, by order of the Commission or by any applicable statute,
				  the day of the action or default initiating the designated period of time not
				  be included. The last day of the period so computed is to be included unless it
				  is a day on which the office of the Commission is closed, in which event the
				  period runs until the end of the next day on which the office of the Commission
				  is open. When the period of time allowed is more than 5 days, intermediate
				  Saturdays, Sundays, and legal holidays shall be considered in the same manner
				  as other days, but if the period of time allowed is 5 days or less,
				  intermediate Saturdays, Sundays, and legal holidays may be not counted in
				  computing the period of time.
B. At
				  the discretion of the Executive Director or his designee and, upon reasonable
				  cause being shown by the submitting party, a period of time to submit a
				  document or perform any other act permitted or prescribed by these regulations
				  may be extended for a reasonable period of time.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.22 - Motions

Current through Register Vol. 51, No. 14, July 12, 2024
A. Motions shall be
				  in writing, except when made at a hearing or conference and shall state
				  concisely the question which the Commission is called upon to determine, or the
				  action the movant desires the Commission to take. It shall state all reasons,
				  authorities, and citations in the body of the motion or in a supporting
				  memorandum. A certificate of service, setting forth all parties upon whom a
				  copy of the motion was served, shall be attached to the motion.
B. The following actions shall be taken by
				  motion:
(1) Objections to actions of the
				  Commission, or the Commission's staff; motions for clarification or
				  reconsideration may not stay the orders of the Commission;
(2) Demands for actions which the movant
				  desires the Commission, or the Commission's staff to take;
(3) Showing reasonable cause why an Order
				  Nisi should not become effective;
(4) Presenting a proper and justifiable
				  question to the Commission;
(5)
				  Objections to the introduction of statements or other evidence by another party
				  during a proceeding;
(6) Challenges
				  to members of the Commission;
(7)
				  Proposals for stipulations;
(8)
				  Answers to prior motions; and
(9)
				  All other actions which might be initiated properly or undertaken by a party to
				  a proceeding and which are not otherwise provided for in these
				  regulations.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.23 - Subpoenas

Current through Register Vol. 51, No. 14, July 12, 2024
A. At any time, the
				  Commission may issue subpoenas directing a designated person to do the
				  following:
(1) Appear to testify at a hearing
				  or private pre-hearing conference conducted by the Commission:
(2) Appear at a specified time and date at
				  the Commission offices or any designated place within the State, and, under
				  oath or otherwise, give testimony and answer questions of the Commission or its
				  authorized representatives; or
(3)
				  Produce documents, reports, or records of a particular activity for a specific
				  period of time if he has custody of or access to the documents, reports, or
				  records; the records may be in any reasonable form; the production shall be
				  made at a specified time, date, and place.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.24 - Effective Dates and Suspensions

Current through Register Vol. 51, No. 14, July 12, 2024
A. The effective date of rates applied for in
				  a rate application shall be 30 days from the date of the filing of the rate
				  application with the Commission and shall be specified in the rate
				  application.
B. The Commission's
				  staff may recommend the suspension of the effective date of the rates under
				  review.
C. At any time during a
				  rate review, the Commission may order a suspension of the effective date of the
				  rates under review, within the time specifications of Health-General Article,
				  §19-219, Annotated Code of Maryland, and shall state the grounds for its
				  action.
Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.10 - Rate Application and Approval Procedures › Section 10.37.10.26 - Patient Rights and Obligations; Hospital Credit and Collection and Financial Assistance Policies

Current through Register Vol. 51, No. 14, July 12, 2024
A.
				  Hospital Information Sheet.
(1) Each hospital
				  shall develop an information sheet that:
(a)
				  Describes the hospital's financial assistance policy;
(b) Describes a patient's rights and
				  obligations with regard to hospital billing and collection under the
				  law;
(c) Provides contact
				  information for the individual or office at the hospital that is available to
				  assist the patient, the patient's family, or the patient's authorized
				  representative in order to understand:
(i)
				  The patient's hospital bill;
(ii)
				  The patient's rights and obligations with regard to the hospital bill,
				  including the patient's rights and obligations with regard to reduced-cost,
				  medically necessary care due to a financial hardship;
(iii) How to apply for free and reduced-cost
				  care; and
(iv) How to apply for the
				  Maryland Medical Assistance Program and any other programs that may help pay
				  the bill;
(d) Provides
				  contact information for the Maryland Medical Assistance Program;
(e) Includes a statement that physician
				  charges, to both hospital inpatients and outpatients, are generally not
				  included in the hospital bill and are billed separately;
(f) Informs patients that the hospital is
				  permitted to bill outpatients a fee, commonly referred to as a "facility fee",
				  for their use of hospital facilities, clinics, supplies and equipment, and
				  nonphysician services, including but not limited to the services of
				  nonphysician clinicians, in addition to physician fees billed for professional
				  services provided in the hospital;
(g) Informs patients of their right to
				  request and receive a written estimate of the total charges for the hospital
				  nonemergency services, procedures, and supplies that reasonably are expected to
				  be provided and billed for by the hospital;
(h) Informs a patient or a patient's
				  authorized representative of the right to file a complaint with the Commission
				  or jointly with the Health Education and Advocacy Unit of the Maryland Attorney
				  General's Office against a hospital for an alleged violation of Health-General
				  Article, §§ 19-214.1 and 19-214.2, Annotated Code of Maryland, which
				  relate to financial assistance and debt collection; and
(i) Provides the patient with the contact
				  information for filing the complaint.