Maryland Administrative Code

.08 Rates for Identified Physician Cost. A. Any hospital which incurs or accrues costs as a result of professional medical services which are personally rendered for an individual patient by a physician, and which contribute to the diagnosis or treatment of an individual patient,…

.09 Rates for Non-Physician Services Provided to Hospital Inpatients by Third-Party Contractors. A. A non-physician inpatient service is defined as a hospital service under the jurisdiction of the Commission provided by a third-party contractor to a hospital inpatient off-site of…

.10 Rates for Services with Revenues Exempt from Commission Jurisdiction. 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 annua…

.01 Collection and Submission of Data. A. Effective January 1, 2014, each hospital under the jurisdiction of the Health Services Cost Review Commission (Commission) shall submit the data elements as published in the Maryland Register and on the Commission's website (http://www.hs…

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Health Services Cost Review Commission (Commission)” means the independent organization within the Maryland Department of Health that is responsible for reviewing and appr…

.03 Privacy of Information. Data submitted to the Commission in accordance with this chapter are not public information pursuant to Health-General Article, §19-207, Annotated Code of Maryland.

.04 Summary Studies, Reports, Compilations. Summary studies, reports, or other compilations developed by the Commission or Commission staff from data submitted in accordance with this chapter shall be public information provided that, consistent with statutory law, disclosure is …

.05 Corrections to Data. The Commission shall prescribe the process for hospitals to submit corrections and revisions to the data on its website.

.01 Collection and Submission of Data. A. Beginning on January 1, 2014, each hospital under the jurisdiction of the Health Services Cost Review Commission shall submit to the Commission: (1) The data elements required by this chapter within 15 days after the last day of the month…

.01-1 Out-of-State Hospitals. A. The requirements for the collection and submission of data as described in Regulation .01 of this chapter shall also apply to those non-federal acute care hospitals located in Delaware, Pennsylvania, Virginia, West Virginia, and the District of Co…

.02 Uniform Hospital Discharge Abstract Data Set. Data Elements are as published in the Maryland Register and on the Commission's website (http://www.hscrc.state. md.us).

.03 Privacy of Information. Data submitted in accordance with this chapter are not public information pursuant to Health-General Article, §19-207(d), Annotated Code of Maryland.

.04 Summary Studies, Reports, Compilations. Summary studies, reports, or other compilations developed by the Commission or its staff from the data submitted in accordance with this chapter shall be public information except that disclosure may not be made in a way that the data f…

.05 Corrections to Data. The Commission shall prescribe the process for hospitals to submit corrections and revisions to the data on its website.

.01 Purpose. The purpose of these regulations is to enable the Commission to fully measure and compare hospital-specific performance on readmissions and to use the data to further enhance and strengthen the financial incentives linked with performance.

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Health Information Exchange (HIE)” means an infrastructure that provides organizational and technical capabilities for the exchange of protected health information electro…

.03 Hospital Participation. Effective December 1, 2011, each hospital under the jurisdiction of the Commission shall electronically connect to the State-Designated HIE to enable the Commission to fully measure hospital-specific performance on readmissions using the HIE’s MPI.

.04 Method of Connection. Each hospital shall establish connectivity with the State-Designated HIE over a secure and encrypted connection. This connectivity shall be established using industry standards specified by the State-Designated HIE.

.05 Collection and Submission of Master Patient Index Data. Each hospital under the jurisdiction of the Commission shall collect and electronically submit to the State-Designated HIE the data elements as published in the Maryland Register and on the Commission’s website (http://w…

.06 Privacy of Information. Data submitted in accordance with this chapter are not public information pursuant to Health-General Article, §19-207(d), Annotated Code of Maryland. The Commission will take reasonable steps to safeguard and protect the confidentiality of protected he…

.07 Summary Studies, Reports, Compilations. Summary studies, reports, or other compilations developed by the Commission or its staff from the data submitted in accordance with this chapter shall be public information except that disclosure may not be made in such a way that the d…

.08 Corrections to Data. The Commission shall prescribe on its website the process for a hospital to submit corrections and revisions to the data it has submitted.

.09 Required Report. Data submitted in accordance with this chapter shall be considered a required report under COMAR 10.37.01.03N.

.01 Frequency. Public meetings of the Commission may be held where and when the Commission directs for any authorized purpose, provided, however, that at least six meetings are held per year.

.02 Attendance. 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.

.03 Presiding Officer. 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 busines…

.04 Agenda. The Executive Director of the Commission in consultation with the Chairman shall be responsible for developing the agenda for each public meeting.

.05 Records. 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.

.06 Voting. 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 ti…

.07 Adjournment. A public meeting may be adjourned by a majority of those Commission members present in person.

.01 Definitions. 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 en…

.02 Special Rate Adjustment and Collection. 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…

.03 Payment of Remittance Due. 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 …

.04 Use of Funds. 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…

.05 Repealed.

.06 Failures or Delay in Paying Remittance/Penalties. 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 t…

.01 Definitions. 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 s…

.01-1 Incorporation by Reference. The Alternative Rate Setting Method (ARM) Manual (1998) is hereby incorporated by reference.

.02 Rate Review System. 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. B. The rate review system is incorporated by …

.03 Regular Rate Applications. 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.…

.03-1 Partial Rate Application. 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 Regulat…

.04 Commission Review of Established Rates. 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 proceed…

.04-1 Rate Efficiency Methodology. A. In evaluating the reasonableness of a hospital's permanent rate structure, the Commission shall use an Inter-hospital Cost Comparison (ICC) methodology, which compares the costs of the hospital to those costs, including adjustments for reason…

.04-2 Global Budget Revenue Methodology. 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 …

.04-3 Global Budget Revenue Mechanism. 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…

.05 Application for Temporary Change in Rates. 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…

.06 Application for Alternative Method of Rate Determination. 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 re…