Code of Maryland Regulations › Title 10 - MARYLAND DEPARTMENT OF HEALTH › Part 5 › Subtitle 37 - HEALTH SERVICES COST REVIEW COMMISSION › Chapter 10.37.03 - Types and Classes of Charges Which Cannot Be Changed Without Prior Commission Approval › Section 10.37.03.10 - Rates for Services with Revenues Exempt from Commission Jurisdiction

Current through Register Vol. 51, No. 14, July 12, 2024
A. Generally. The
				  Commission may, on its own or upon application from a hospital, permit charges
				  for services to be changed without its prior approval in those cases when
				  66-2/3 percent or more of the annual gross patient revenue attributable to the
				  services is derived from either Medicaid or Medicare patients, or both, who are
				  not required by State law or by the terms of the Medicare Waiver to pay
				  Commission-approved rates for those services. The Commission shall consider
				  this action only in those instances when the annual gross revenue for
				  nonphysician services is not more than $20 million (in 1996 dollars), adjusted
				  by an appropriate index of inflation, or when the annual gross revenue subject
				  to Commission rate-setting jurisdiction is not more than $5 million (in 1996
				  dollars) adjusted by an appropriate index of inflation.
B. Filing of Application. A hospital seeking
				  a rate-setting exemption under this regulation shall file a written application
				  with the Commission identifying the service or services for which the exemption
				  is requested. The application shall contain accurate and supporting
				  documentation that the conditions set forth in §A of this regulation have
				  been met for a minimum period of 12 months immediately before the application.
				  The filing of an application for a rate-setting exemption does not constitute a
				  contested case within the meaning of that term as defined in the Administrative
				  Procedure Act.
C. Review of
				  Application. The Commission staff shall review the application within a
				  reasonable period of time and prepare a written recommendation on the request
				  to the Commission. The decision to grant or deny the application rests within
				  the sound discretion of the Commission.
D. Required Reports. A hospital granted an
				  exemption under this regulation is required to file quarterly reports, in a
				  manner to be prescribed by the Commission, in order to verify that the
				  conditions set forth in §A of this regulation still obtain. The hospital
				  shall continue to file all other required reports in conformity with the
				  Commission's Accounting and Budget Manual for Fiscal and Operating Management
				  (the Manual), which is incorporated by reference under COMAR
				  10.37.01.02A.
E. Attestation. Responsible
				  officials of an applicant hospital are required to attest that, to the best of
				  their knowledge and belief, the reports filed, as required under §D of
				  this regulation, have been prepared in conformity with the Commission's uniform
				  accounting and financial reporting system as set forth in the Manual.
F. Further Investigation. If the Commission
				  considers a further investigation necessary or desirable to authenticate
				  information reported by a hospital seeking a rate-setting exemption, the
				  Commission may make any further examination of the records or accounts of the
				  hospital in accordance with the rules or regulations of the
				  Commission.
G. Termination of
				  Exemption. The Commission may terminate an exemption granted under this
				  regulation at any time for cause.