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Ch. 216
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2006 LAWS OF MARYLAND
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function: (2) evaluate those individuals
through the use of a serum creatinine test
and an estimated glomerular filtration
rate (GFR) calculation to identify the
stage of kidney disease: and (3) determine
if early identification and appropriate
management of risk factors can improve
health conditions and prolonged kidney
function, thereby delaying disease
progression to End Stage Renal Disease.
DHMH shall also continue to prepare
information for physicians and other
health care providers regarding generally
accepted standards of clinical care in the
clinical management of high risk
individuals and shall report to the budget
committees by January 1, 2007 on
projected cost savings and health
outcomes that result from early
identification and clinical management of
individuals at highest risk for CKD.
It is the intent of the General Assembly that
rates paid to Medicaid managed care
organizations (MCOs) be adequate and
actuarially sound under Section 15-103 of
the Health General Article and remain
actuarially sound after any mid-year
adjustment. Inpatient hospital costs
represent a significant portion of the costs
incurred by MCOs, and such costs shall be
reflected in the rates paid to MCOs. The
Department of Health and Mental
Hygiene (DHMH) and the Health Services
Cost Review Commission shall jointly
analyze and report back to the budget
committees before July 1, 2006, on
whether:
(1) the rates paid to MCOs for the calendar
years 2004 and 2005 reflected the
actual inpatient hospital
charge per case trend applicable to
MCOs, and if not, the amount of any
shortfall;
(2) the rates to be paid to MCOs for the
calendar year 2006 adequately reflect
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