Opinion ID: 1884591
Heading Depth: 2
Heading Rank: 2

Heading: Statutory Framework in Maryland

Text: The Maryland General Assembly established the Commission on October 1, 1999 through legislative enactment, see 1999 Md. Laws, ch. 702; Md.Code (1982, 2000 Repl.Vol., 2001 Supp.) § 19-103 of the Health General Article, by merging the Health Resources Planning Commission and the Health Care Access and Cost Commission. [3] The Commission, which is an independent commission in the Department of Health and Mental Hygiene, § 19-103(a) and (b), with significant responsibilities for the delivery of health care in Maryland and exercises regulatory authority over several aspects of the health care system in Maryland, is comprised of a thirteen member panel, appointed by the Governor with the advice and consent of the Maryland Senate. § 19-104. The purpose of the Commission, as defined by the Legislature, is, in part, to: Develop health care cost containment strategies to help provide access to appropriate quality health care services for all Marylanders, after consultation with the Health Services Cost Review Commission; Promote the development of a health regulatory system that provides for all Marylanders, financial and geographical access to quality health care services at a reasonable cost by: (i) Advocating policies and systems to promote the efficient delivery of and improved access to health care services; and (ii) Enhancing the strengths of the current health care service delivery and regulatory system. Section 19-103(c)(1) and (2). Toward that end, the Commission is charged with participating in or performing, periodically, analyses and studies relating to: (i) Adequacy of services and financial resources to meet the needs of the population; (ii) Distribution of health care resources; (iii) Allocation of health care resources; (iv) Costs of health care in relationship to available financial resources; or (v) Any other appropriate matter. Section 19-115(a)(2). The Commission is also required, [a]t least every 5 years ... [to] adopt a State [H]ealth [P]lan.... Section 19-121(a)(1). [4] Section 19-121(a)(2) provides: (2) The plan shall include: (i) A description of the components that should comprise the health care system; (ii) The goals and policies for Maryland's health care system; (iii) Identification of unmet needs, excess services, minimum access criteria, and services to be regionalized; (iv) An assessment of the financial resources required and available for the health care system; (v) The methodologies, standards, and criteria for certificate of need review; and (vi) Priority for conversion of acute capacity to alternative uses where appropriate. The Commission uses the State Health Plan as a tool to identify the need for medical services and for evaluating CON applications submitted by health service providers. The Commission's specific mandate by the Legislature is to review and, where appropriate, issue certificates of need to permit a person to develop[ ], operate[ ], or participate[ ] in certain health care projects. § 19-123(e), et seq. A new cardiac surgery service is one such health care project. § 19-123(j)(2)(iii)(2). In addition to including methodologies, standards and criteria for CON review in the State Health Plan, the Commission is charged with developing, consistent with the State Health Plan, standards and policies relating to the CON program that address the availability, accessibility, cost and quality of health care and reviewing those standards and policies periodically to reflect new developments in health planning, delivery, and technology. Section 19-122(e)(1) and (2). Moreover, standards regarding cost, efficiency, cost effectiveness or financial feasibility adopted by the Commission shall take into account the relevant methodologies of the Health Services Cost Review Commission. Id., § 19-121(e)(3). And the Commission is required to adopt rules and regulations that ensure broad public input, public hearings, and consideration of local health plans in development of the State health plan. Id., § 19-121(d).