Home Table of Contents

§ 15-103.5. Review of rates paid to providers

West's Annotated Code of MarylandHealth--GeneralEffective: July 1, 2019

West's Annotated Code of Maryland
Health--General
Title 15. Assistance Programs (Refs & Annos)
Subtitle 1. Medical and Pharmacy Assistance Programs (Refs & Annos)
Effective: July 1, 2019
MD Code, Health - General, § 15-103.5
§ 15-103.5. Review of rates paid to providers
In general
(a) For the calendar year prior to the report date under subsection (b) of this section, the Department shall review the rates paid to providers under the federal Medicare fee schedule and compare the rates under the Medicare fee schedule to the fee-for-service rates paid to similar providers for the same services under the Maryland Medical Assistance Program and the rates paid to managed care organization providers for the same services under the Maryland Medical Assistance Program.
Time and contents of report
(b) On or before January 1, 2010, and each January 1 thereafter, the Department shall report, in accordance with § 2-1257 of the State Government Article, to the Senate Finance Committee and the House Health and Government Operations Committee on:
(1) The review and comparison under subsection (a) of this section;
(2) Whether the fee-for-service rates and managed care organization provider rates will exceed the rates paid under the Medicare fee schedule for the period covered by the review required under subsection (a) of this section;
(3) An analysis of the fee-for-service reimbursement rates paid in other states and how those rates compare with those in the State;
(4) A schedule for bringing the State's fee-for-service reimbursement rates to a level that assures that all health care providers are reimbursed adequately to provide access to care; and
(5) An analysis of the estimated costs of implementing the schedule and any proposed changes to the fee-for-service reimbursement rates for the Maryland Medical Assistance Program and the Maryland Children's Health Program.

Credits

Added by Acts 2009, c. 656, § 1, eff. Oct. 1, 2009. Amended by Acts 2019, c. 8, § 5.
MD Code, Health - General, § 15-103.5, MD HEALTH GEN § 15-103.5
Current through legislation effective through June 1, 2022, from the 2022 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
End of Document