Ch. 9                                             1993 LAWS OF MARYLAND

(V) THE IMPACT OF ADOPTING A UNIFORM FEE SCHEDULE ON
ACCESS TO HEALTH CARE SERVICES RENDERED BY PRACTITIONERS AND OFFICE
FACILITIES;

(VI) THE IMPACT ON PAYORS OF ADOPTING A UNIFORM FEE
SCHEDULE INCLUDING THE IMPACT ON THE MEDICAL ASSISTANCE PROGRAM;

(VII) THE FEASIBILITY AND DESIRABILITY OF ADJUSTING THE FEE
SCHEDULE TO INCLUDE THE REASONABLE COST OF BAD DEBT AND CHARITY CARE
RENDERED BY PHYSICIANS AND OFFICE FACILITIES; AND

(VIII) THE FEASIBILITY OF INCLUDING ADJUSTMENTS TO THE FEE
SCHEDULE TO RECOGNIZE DIFFERENCES IN EXPERIENCE OR EXPERTISE AMONG
PHYSICIANS;

(D) IN DEVELOPING THE PAYMENT SYSTEM, THE COMMISSION SHALL
CONSULT WITH INTERESTED PARTIES, INCLUDING REPRESENTATIVES OF
PHYSICIANS, HOSPITALS, PAYORS, AND THE HEALTH SERVICES COST REVIEW
COMMISSION;

19-1509.

(A) (1) IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.

(2) "C.P.T. CODE" MEANS THE CURRENT PROCEDURAL TERMINOLOGY AS
ADOPTED BY THE AMERICAN MEDICAL ASSOCIATION.

(3) "PAYOR" MEANS A HEALTH INSURER, NONPROFIT HEALTH SERVICE
PLAN, OR HEALTH MAINTENANCE ORGANIZATION THAT HOLDS A CERTIFICATE OF
AUTHORITY TO OFFER HEALTH INSURANCE POLICIES OR CONTRACTS IN THE STATE IN
ACCORDANCE WITH ARTICLE 48A OF THE CODE OR THE HEALTH - GENERAL ARTICLE.

(4) "UNBUNDLING" MEANS THE USE OF TWO OR MORE CPT CODES TO
DESCRIBE A SURGERY OR SERVICE PROVIDED TO A PATIENT WHEN A SINGLE, MORE
COMPREHENSIVE CRT. CODE EXISTS THAT ACCURATELY DESCRIBES THE ENTIRE
SURGERY OR SERVICE. "UNBUNDLING" INCLUDES THE PRACTICE OF CLAIMING
REIMBURSEMENT FOR A MEDICAL VISIT IN CONJUNCTION WITH SURGERY WHEN THE
CLAIMED MEDICAL VISIT IS ON THE SAME DATE AS THE SURGERY.

(B) (1) ON OR BEFORE JANUARY 1, 1995, THE COMMISSION SHALL DEVELOP
AND IMPLEMENT A PAYMENT SYSTEM FOR ALL HEALTH CARE PRACTITIONERS IN THE
STATE.

(2) THE PAYMENT SYSTEM ESTABLISHED UNDER THIS SECTION SHALL
INCLUDE A METHODOLOGY FOR A UNIFORM SYSTEM OF HEALTH CARE PRACTITIONER
REIMBURSEMENT.

(3) UNDER THE PAYMENT SYSTEM, REIMBURSEMENT FOR EACH HEALTH
CARE PRACTITIONER SHALL BE DERIVED BY MULTIPLYING THE FOLLOWING NUMERIC
FACTORS:

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