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§ 19-219. Review of costs and rates

West's Annotated Code of MarylandHealth--GeneralEffective: October 1, 2023

West's Annotated Code of Maryland
Health--General
Title 19. Health Care Facilities (Refs & Annos)
Subtitle 2. Health Services Cost Review Commission (Refs & Annos)
Part II. Health Care Facility Rate Setting
Effective: October 1, 2023
MD Code, Health - General, § 19-219
§ 19-219. Review of costs and rates
<Section effective until occurrence of contingency specified in Acts 2008, c. 244, § 4, and Acts 2008, c. 245, § 4. See, also, section 19-219 effective upon occurrence of contingency specified in Acts 2008, c. 244, § 4, and Acts 2008, c. 245, § 4.>
In general
(a) The Commission may review the costs, and rates, quality, and efficiency of facility services, and make any investigation that the Commission considers necessary to assure each purchaser of health care facility services that:
(1) The total costs of all hospital services offered by or through a facility are reasonable;
(2) The aggregate rates of the facility are related reasonably to the aggregate costs of the facility; and
(3) The rates are set equitably among all purchasers or classes of purchasers without undue discrimination or preference.
Reasonableness of rates
(b)(1) To carry out its powers under subsection (a) of this section, the Commission may review and approve or disapprove the reasonableness of any rate or amount of revenue that a facility sets or requests.
(2) A facility shall:
(i) Charge for services only at a rate set in accordance with this subtitle; and
(ii) Comply with the applicable terms and conditions of the all-payer model contract.
(3) Consistent with the all-payer model contract, in determining the reasonableness of rates, the Commission may take into account objective standards of efficiency and effectiveness.
Alternate methods of rate determination
(c) Consistent with the all-payer model contract, and notwithstanding any other provision of this subtitle, the Commission may:
(1) Establish hospital rate levels and rate increases in the aggregate or on a hospital-specific basis;
(2) Promote and approve alternative methods of rate determination and payment of an experimental nature for the duration of the all-payer model contract; and
(3) On request of the Secretary, assist in the implementation of federally approved model programs.

Credits

Added as Health-General § 19-216 by Acts 1982, c. 21, § 2, eff. July 1, 1982. Amended by Acts 1984, c. 470, § 1, eff. July 1, 1984; Acts 1985, c. 10, § 3, eff. July 1, 1985; Acts 1985, c. 112, § 1, eff. June 1, 1985. Renumbered as Health-General § 19-219 and amended by Acts 1999, c. 702, § 2, eff. Oct. 1, 1999. Amended by Acts 2002, c. 153, § 4, eff. Jan. 1, 2003; Acts 2003, c. 1, § 1, eff. April 8, 2003; Acts 2008, c. 244, § 1, eff. July 1, 2008; Acts 2008, c. 245, § 1, eff. July 1, 2008; Acts 2014, c. 263, § 1, eff. July 1, 2014; Acts 2015, c. 263, § 1, eff. Oct. 1, 2015; Acts 2020, c. 505, § 1, eff. July 1, 2020; Acts 2023, c. 373, § 1, eff. Oct. 1, 2023; Acts 2023, c. 374, § 1, eff. Oct. 1, 2023.
Formerly Art. 43, § 568U.
MD Code, Health - General, § 19-219, MD HEALTH GEN § 19-219
Current through legislation effective through May 9, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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