1536                                          LAWS OF MARYLAND                                      Ch. 110

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) AN INSURER PROVIDING GROUP HEALTH INSURANCE OR BLANKET
HEALTH INSURANCE UNDER SUBSECTION (A) OF THIS SECTION MAY NOT
SUBSIDIZE THESE BENEFITS FROM PREMIUMS EARNED BY OTHER BENEFIT
PLANS OR POLICIES.

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall
take effect June 1, 1985.

Approved May 21, 1985.

CHAPTER 111

(House Bill 1071)

AN ACT concerning

Health Care Cost Containment - Utilization Review

FOR the purpose of reducing unnecessary hospital use by requiring
each hospital to establish a utilization review program for