Maryland Administrative Code

.05 Performance and Monitoring. A. Each Registry hospital shall provide data to the Commission in a form and manner acceptable to the Commission. B. Each Registry hospital shall submit periodic progress reports in a format specified by the Commission and, at the conclusion of the…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Commission” means the Maryland Health Care Commission. (2) “Non-hospital health care facility” means: (a) A related institution, as defined in Health-General Article, §19-…

.02 Collection and Reporting of Data. A. A non-hospital health care facility shall submit accurate, timely, and complete data which the Commission considers to be necessary for planning and analysis purposes, as requested by the Commission. B. The information requested by the Com…

.03 Summary Studies, Reports, and Compilations. A. Subject to §B of this regulation, summary studies, reports, or other compilations developed by the Commission from the data submitted in accordance with this chapter are public information. B. Disclosure under §A of this regulati…

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Residential Treatment Centers is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Special Hospital — Chronic Services is incorporated by reference.

.01 Incorporation by Reference. A. In this chapter, the following documents are incorporated by reference. B. Documents Incorporated. (1) The State Health Plan for Facilities and Services: Specialized Health Care Services — Acute Inpatient Rehabilitation Services. (2) Supplement …

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Acute Care Hospital Services is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: General Surgical Services is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Acute Hospital Inpatient Obstetric Services (Supplement No. 1) is incorporated by reference.

.01 Incorporation by Reference The State Health Plan for Facilities and Services: Hospice Services is incorporated by reference.

.01 Incorporation by Reference. A. In this chapter, the following documents are incorporated by reference. B. Documents Incorporated. (1) The State Health Plan for Facilities and Services: Alcoholism and Drug Abuse Intermediate Care Facility Treatment Services. (2) Supplement No.…

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Specialized Health Care Services — Organ Transplant Services is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Home Health Agency Services is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Specialized Health Care Services — Cardiac Surgery and Percutaneous Coronary Intervention Services is incorporated by reference.

.01 Incorporation by Reference. A. In this chapter, the following documents are incorporated by reference. B. Documents Incorporated. (1) The State Health Plan: Specialized Health Care Services — Neonatal Intensive Care Services. (2) Supplement No. 1. (3) Supplement No. 2.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Freestanding Medical Facilities is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Comprehensive Care Facility (Nursing Home) Services is incorporated by reference.

.01 Incorporation by Reference. The State Health Plan for Facilities and Services: Acute Psychiatric Services is incorporated by reference.

.01 Scope. A. This chapter only applies to the Small Employer Health Benefit Plan Premium Subsidy Program as authorized by Insurance Article, §§15-12A-01 — 15-12A-05, Annotated Code of Maryland. B. Premium subsidies authorized under this chapter shall only be provided for health …

.02 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Affiliated companies” means companies that are eligible to file a consolidated federal income tax return. (2) “Average wage of business” means the average of the annual wa…

.03 Purpose. The Premium Subsidy Program is designed to: A. Provide an incentive for small employers to offer and maintain a small employer health benefit plan for their employees; B. Help low and moderate wage employees of small employers afford health benefit plan premiums; C. …

.04 Employer Eligibility. A. A small employer is eligible to receive a premium subsidy if, at the time of initial application for the premium subsidy, the employer: (1) Meets the requirements under Insurance Article, §15-1203(b)(i), Annotated Code of Maryland; (2) Has been in ope…

.05 Employee Eligibility. A. An eligible employee of a small employer is eligible to receive the premium subsidy if, at the time of initial application and at the time of each renewal application: (1) The small employer meets the requirements of Regulation .04 of this chapter; (2…

.06 Employee Selection of Other Than Individual Coverage. A. An eligible employee may apply for a premium subsidy for other than individual coverage if the eligible employee's family adjusted gross income does not exceed the maximum income for other than individual coverage. B. A…

.07 Initial Application and Enrollment. A. Initial application for the Premium Subsidy Program shall be made according to the procedures designated by the Commission and published on the Commission's official website. B. The small employer shall complete an initial application pu…

.08 Application and Enrollment of Additional Employees During the Policy Year. A. A newly hired eligible employee of an enrolled employer, an employee who becomes an eligible employee during the policy year, or an eligible employee who qualifies for a special enrollment period un…

.09 Renewal Application. A. The enrolled employer shall complete a renewal application published on the Commission's official website. The renewal application shall include: (1) Information necessary to establish the eligibility of the employer and the amount of the available pre…

.10 Calculation of the Average Wage of Business. A. The average wage of business is the average of the wage for each of the eligible employees of the business. B. For employees who are eligible owners, the wage used in calculating the average wage of business shall be the greater…

.11 Calculation of the Premium Subsidy. A. At the time of initial application for the Premium Subsidy Program, the premium subsidy is the lower of: (1) The amount from the maximum subsidy table applicable for the average wage of business and the type of coverage chosen by the emp…

.12 Change in Employer's Federal Employer Identification Number. If the federal employer identification number of the employer changes, because the company changes its form of ownership or for any other reason, the company may petition the Commission for continued eligibility for…

.13 Change of Participating Carrier by the Enrolled Employer. A. If the enrolled employer elects to change coverage from one participating carrier to a different participating carrier at the time of policy renewal and premium subsidy renewal, the enrolled employer shall identify …

.14 Payment of the Premium Subsidy. A. Payment of the total premium subsidy is subject to the following: (1) The total premium subsidy for each enrolled employer shall be paid to the subsidy administrator and shall reduce the total premium owed by the enrolled employer; (2) The e…

.15 Carrier Requirements. A. To participate in the Premium Subsidy Program, a carrier shall meet the definition of a participating carrier under Regulation .02B(34) of this chapter. B. The written participation agreement shall include: (1) The carrier's designation of its subsidy…

.16 Licensed Insurance Producer Requirements. A licensed insurance producer in connection with the sale, solicitation, or negotiation of a health benefit plan to a small employer who meets the requirements described in Regulation .04 of this chapter shall: A. Provide information …

.17 Premium Subsidy Program Design Factors. A. At least once each year, the Commission shall publish on the Commission's official website for informal public comment a list of the proposed Premium Subsidy Program design factors, including: (1) Eligible owner's countable wage; (2)…

.18 Closing the Premium Subsidy Program to the Entry of New Businesses. A. The Executive Director may close the program to the entry of new businesses by closing the Commission registry to new registration, notifying the participating carriers, and posting notice on the Commissio…

.19 Closing the Premium Subsidy Program to the Entry of Additional Employees of Enrolled Employers. A. The Executive Director may close the Premium Subsidy Program to the entry of new employees by closing the Commission registry to registration of additional employees, notifying …

.20 Reopening the Premium Subsidy Program. A. Following closure of the Premium Subsidy Program under Regulation .18 or .19 of this chapter, the Commission may reopen the Premium Subsidy Program through a formal action specifying both the application process and the criteria that …

.21 Penalties. A. In any conduct relating to the Premium Subsidy Program, employers, employees, participating carriers, subsidy administrators, and licensed insurance producers are subject to criminal and civil penalties under applicable law for any knowing and willful making of …

.22 Decisions of the Commission — Delegation of Program Administration to the Executive Director. A. Decisions of the Commission relating to policies, regulations, and program design under Regulations .17 — .20 of this chapter may not be delegated. B. All other decisions of the C…

.23 Appeals of Decisions of the Executive Director. A. Decisions of the Executive Director may be appealed to the Commission. B. The appeal shall be in writing and filed with the Commission within 30 days of the date of the decision of the Executive Director. C. The appeal shall …

.24 Appeals of Decisions of a Participating Carrier. Actions taken by a participating carrier, including actions taken by a participating carrier that affect a small employer's eligibility for participation in the Premium Subsidy Program or the amount of the premium subsidy, shal…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated: B. Terms Defined. (1) “Affected licensing board” means a licensing board of which all licensees are required by the Commissioner to pay a user fee. (2) “Commission” means the Maryland Health Car…

.02 Method of User Fee Assessment. A. The Commission annually shall identify the health care practitioners to be assessed a user fee. B. Based on the Commission budget, the Commission shall establish a fee schedule which sets forth the fee that each health care practitioner shall…

.03 Waiver of the Fee Assessment Requirements. A. The Commission shall identify the average annual wage for health care practitioners by using comparable classifications in the State Classification and Salary Compensation Plan. B. The Commission shall determine the average annual…

.01 Definitions. A. In this chapter, the following terms have the meanings indicated. B. Terms Defined. (1) “Assessment” means the total dollar amount that the Commission bills payers, hospitals, and nursing homes for a given fiscal year. (2) “Commission” means the Maryland Healt…