Medicare Parts A and B Under the Buy-In Pro
grams for Medicare, the State, through the Medical
Assistance Program, pays federal premiums for peo
pie certified by the local department of social serv
ices as unable to cover hospital insurance (Part A)
or medical insurance (Part B)

TECHNICAL OPERATIONS
Alan R Shugart, Deputy Director
(410) 767 5408

Under Technical Operations are the MMIS—II
Project, and two divisions Claims Processing, and
Medicaid Information Systems (MMIS)

DIVISION OF CLAIMS PROCESSING
Joseph L Fine, Chief
(410) 767-5795

The Division of Claims Processing started as the
Division of Invoice Processing and received its present
name m 1989 The Division processes all claims for
payment made by providers of health care services
under the Medical Assistance, Pharmacy Assistance
and Prenatal Assistance Programs Processing in
eludes mail sorting, microfilming, entry of claims into
the Batch and Invoice Control File of the Medicaid
Management Information System, and processing of
payments in excess of $1 5 billion annually for 12
million claims received The Division maintains re-
cords of payments to, as well as collection from, the
more than 25,000 health care providers enrolled in
the Medical Assistance Program The Division also
serves as a centralized purchasing and inventory unit
for the Administration

DIVISION OF MEDICAID INFORMATION SYSTEMS
Vacancy, Chief
(410) 767 5408

Established in 1982, the Division of Medicaid
Information Systems serves as the data processing
unit for Medical Care Programs The Division per
forms systems analysis and programming, and
maintains a teleprocessing network It maintains
and operates the Medicaid Management Informa-
tion System (MMIS), an automated claims process
ing and information retrieval system mandated by
the federal government The Division also provides
data processing for the Geriatric Evaluation Serv
ices. Pharmacy Assistance Program, and Statewide
Evaluation and Planning Services

MEDICAID MANAGEMENT INFORMATION
SYSTEM (MMIS—II) PROJECT
John J O'Bnen, Ch»ef
(410) 767 6937

Formed in 1993, the Medicaid Management
Information System (MMIS—II) Project is work
ing to replace the Medicaid Management Informa-
tion System (MMIS) The Project will secure a

certified MMIS from another state, enhance it to
meet Maryland needs, install it on the State corn
puter, and integrate it with new information sys
terns technologies

MARYLAND HEALTH CARE
ACCESS & COST COMMISSION

Donald b Wilson, M D , Chair, 1998
John M Colmers, Executive Director

4201 Patterson Ave
Baltimore, MD 21215—2299 (410) 764 3460

In 1993, the Maryland Health Care Access and
Cost Commission was created as an independent
agency within the Department of Health and Men-
tal Hygiene (Chapter 9, Acts of 1993)
The Commission develops strategies by which
the costs of health care may be limited and access
to health care services extended to all Marylanders
The Commission formulates a uniform set ofbene
fits for the comprehensive standard health benefit
plan, devises a payment system for health care
services, and fosters development of practice pa
rameters The Commission also facilitates public
disclosure of medical claims data for the develop
ment of public policy, maintains and analyzes a
medical care data base on health care provided by
health care practitioners, and ensures the use of that
data base as a primary means to compile data and
annually report on trends, \ anances, and compan
sons regarding fees for service, cost of care, and
malpractice Additionally, the Commission encour
ages the development of clinical resource manage
ment systems that permit cost comparisons
between various treatment settings and the avail-
ability of information to consumers, providers, and
purchasers of health care, sets standards for the
operation and licensing of medical care electronic
claims clearinghouses, and reduces the costs of
submitting and administering claims for health care
practitioners and payers
With Senate advice ind rnnsint, the Governor
appoints the Commission's seven members to four
year terms The Governor also names the chair
(Code Health—General Article, sees 19-1501
through 19 1516)

ADVISORY COMMITTEE ON PRACTICE PARAMETERS

J Ramsay Farah, M D , Chair

The Advisory Committee on Practice Parame-
ters was established in 1993 (C hapter 9, Acts of
1993) The Committee is to study the development
of practice parameters for medical specialties and
advise the Maryland Health Care Access and Cost
Commission on the adoption and use of practice
parameters These parameters are intended to de
fine appropriate clinical indications and methods of