1534

LAWS OF MARYLAND

Ch. 110

BENEFICIARY WHO UTILIZES CERTAIN DESIGNATED LOW-COST HOSPITALS,
DIFFERENT FROM THE BENEFITS OFFERED FOR UTILIZATION OF OTHER
HOSPITALS, SHALL BASE ITS DESIGNATION OF A LOW-COST HOSPITAL ON
INFORMATION WHICH:

(1)  EXCLUDES THE REASONABLE COST OF MEDICAL EDUCATION
AS DETERMINED BY THE HEALTH SERVICES COST REVIEW COMMISSION;

(2)  EXCLUDES THE REASONABLE COST OF UNCOMPENSATED
CARE AS DETERMINED BY THE HEALTH SERVICES COST REVIEW COMMISSION;
AND

(3) EXCLUDES ANY HOSPITAL FROM CONSIDERATION THAT IS
DETERMINED BY THE HEALTH RESOURCES PLANNING COMMISSION TO BE A
SOLE COMMUNITY PROVIDER;

(4) EXCLUDES THE AMOUNT IN RATES AS APPROVED BY THE
HEALTH SERVICES COST REVIEW COMMISSION FOR UNDERGRADUATE NURSING
EDUCATION;

(4) (5) EXCLUDES THE COST, AS DETERMINED BY THE
HEALTH SERVICES COST REVIEW COMMISSION, ASSOCIATED WITH:

(I) ANY SHOCK TRAUMA FACILITY; OR
(II) ANY SPECIALTY CARE UNIT; AND

(3) (5) (6) COMPARES HOSPITALS ON A REGIONAL BASIS

UNLESS THE INSURER DEMONSTRATES TO THE SATISFACTION OF THE

INSURANCE COMMISSIONER THAT A STATEWIDE COMPARISON IS MORE
APPROPRIATE UNDER THE CIRCUMSTANCES.

(B) A NONPROFIT HEALTH SERVICE PLAN PROVIDING BENEFITS

UNDER A PLAN DEFINED IN SUBSECTION (A) OF THIS SECTION MAY NOT

SUBSIDIZE THE BENEFITS OFFERED UNDER SUCH PLAN FROM PREMIUMS
EARNED BY OTHER BENEFIT PLANS OR PROGRAMS.

361G.

(A)  IN THIS SECTION, "HEALTH CARE PROVIDER" MEANS:

(1)  A LICENSED HEALTH CARE PROFESSIONAL;

(2)  AN ADMINISTRATOR OF A HOSPITAL; OR
(3) A TRUSTEE OF A HOSPITAL; OR

(4)(3) AN EMPLOYEE OF A HEALTH CARE PROFESSIONAL OR
HOSPITAL.

(B)  NO MORE THAN 25% OF THE BOARD OF DIRECTORS OF A
NONPROFIT HEALTH SERVICE PLAN SHALL BE HEALTH CARE PROVIDERS.

(C)  THE COMMISSIONER MAY ADOPT RULES AND REGULATIONS WHICH
LIMIT THE REPRESENTATION OF HEALTH CARE PROVIDERS ON A