|
|
|
|
|
|
|
|
|
|
|
|
|
Ch. 550 2005 LAWS OF MARYLAND
SPECIFIED BY THE COMMISSION, ON THE CONFIGURATION, LOCATION, OPERATION,
AND UTILIZATION, INCLUDING PATIENT-LEVEL UTILIZATION, OF THE PILOT
PROJECT.
(2) A CERTIFICATE OF NEED IS NOT REQUIRED FOR A FREESTANDING
MEDICAL FACILITY PILOT PROJECT.
(D) (1) THIS SUBSECTION APPLIES TO:
(I) INDIVIDUAL, GROUP, OR BLANKET HEALTH INSURANCE
POLICIES AND CONTRACTS DELIVERED OR ISSUED FOR DELIVERY IN THE STATE BY
INSURERS, NONPROFIT HEALTH SERVICE PLANS, HEALTH MAINTENANCE
ORGANIZATIONS; AND
(II) MEDICAID MANAGED CARE ORGANIZATIONS.
(2) AN ENTITY SUBJECT TO THIS SUBSECTION SHALL PAY THE CLAIM
FOR COVERED SERVICES SUBMITTED BY A FREESTANDING MEDICAL FACILITY PILOT
PROJECT AT RATES CONSISTENT WITH THE CONTRACT BETWEEN THE ENTITY AND
THE FREESTANDING MEDICAL FACILITY PILOT PROJECT.
(E) THE MARYLAND MEDICAL ASSISTANCE PROGRAM SHALL PAY A
FEE-FOR-SERVICE CLAIM SUBMITTED BY A FREESTANDING MEDICAL FACILITY
PILOT PROJECT AT A RATE AT LEAST EQUAL TO THE RATE PAID BY MEDICARE.
(F) THE PROVISIONS OF §§ 19-3A-01 THROUGH 19-3A-06 SHALL APPLY TO A
FREESTANDING MEDICAL FACILITY PILOT PROJECT.
19-706.
(DDD) THE PROVISIONS OF § 19-3A-07(D) OF THIS TITLE APPLY TO HEALTH
MAINTENANCE ORGANIZATIONS.
SECTION 2. AND BE IT FURTHER ENACTED, That the Maryland Health
Care Commission, in consultation with the Health Services Cost Review Commission,
shall conduct a study of the operations, utilization, and financing of freestanding
medical facilities, using information on the freestanding medical facility pilot project
established in Section 1 of this Act. The findings of the study shall be reported to the
Senate Finance Committee and the House Health and Government Operations
Committee, in accordance with § 2-1246 of the State Government Article, on or before
December 31, 2007.
SECTION 3. AND BE IT FURTHER ENACTED, That, on or before October 1,
2005, the Health Services Cost Review Commission and Shady Grove Adventist
Hospital shall report, in accordance with § 2-1246 of the State Government Article, to
the Senate Finance Committee and House Health and Government Operations
Committee on their progress in obtaining provider-based status from the federal
Centers for Medicare and Medicaid Services for the freestanding medical facility pilot
project established under § 19-3A-07, as enacted by Section 1 of this Act.
SECTION 4. AND BE IT FURTHER ENACTED, That on or before November 1,
2005, the League of Life and Health Insurers, CareFirst, Inc., United Healthcare,
- 3184 -
|
|
|
|
|
|
|
|
|
|
|
|
|
|
 |
