Ch. 9

1993 LAWS OF MARYLAND

8. ANY OTHER FACTORS DEEMED APPROPRIATE BY THE
COMMISSION.

(3) IN MAKING A DETERMINATION UNDER SUBSECTION (B)(3)(II) OF THIS
SECTION CONCERNING THE VALUE OF A HEALTH CARE SERVICE RELATIVE TO OTHER
HEALTH CARE SERVICES, THE COMMISSION SHALL CONSIDER:

(I) THE RELATIVE COMPLEXITY OF THE HEALTH CARE SERVICE
COMPARED TO THAT OF OTHER HEALTH CARE SERVICES;

(II)      THE COGNITIVE SKILLS ASSOCIATED WITH THE HEALTH CARE
SERVICE;

(III)    THE TIME AND EFFORT THAT ARE NECESSARY TO PROVIDE THE
HEALTH CARE SERVICE; AND

(IV)    ANY OTHER FACTORS DEEMED APPROPRIATE BY THE
COMMISSION.

(4) EXCEPT AS PROVIDED UNDER SUBSECTION (D) OF THIS SECTION, A
CONVERSION MODIFIER SHALL BE:

(I) A PAYOR'S STANDARD FOR REIMBURSEMENT;

(II)     A HEALTH CARE PRACTITIONER'S STANDARD FOR
REIMBURSEMENT; OR

(III)    ARRANGEMENTS AGREED UPON BETWEEN A PAYOR OR PATIENT
AND A HEALTH CARE PRACTITIONER.

(D) (1) (I) THE COMMISSION MAY MAKE AN EFFORT, THROUGH VOLUNTARY
AND COOPERATIVE ARRANGEMENTS BETWEEN THE COMMISSION AND THE
APPROPRIATE HEALTH CARE PRACTITIONER SPECIALTY GROUP, TO BRING THAT
HEALTH CARE PRACTITIONER SPECIALTY GROUP INTO COMPLIANCE WITH THE HEALTH
CARE COST GOALS OF THE COMMISSION IF THE COMMISSION DETERMINES THAT:

1. CERTAIN HEALTH CARE SERVICES ARE SIGNIFICANTLY
CONTRIBUTING TO UNREASONABLE INCREASES IN THE OVERALL VOLUME AND COST OF
HEALTH CARE SERVICES;

2. HEALTH CARE PRACTITIONERS IN A SPECIALTY AREA HAVE
ATTAINED UNREASONABLE LEVELS OF REIMBURSABLE SERVICES UNDER A SPECIFIC
C.P.T. CODE IN COMPARISON TO HEALTH CARE PRACTITIONERS IN ANOTHER SPECIALTY
AREA FOR THE SAME C.P.T. CODE;

3. HEALTH CARE PRACTITIONERS IN A SPECIALTY AREA HAVE
ATTAINED UNREASONABLE LEVELS OF REIMBURSEMENT, IN TERMS OF TOTAL
COMPENSATION, IN COMPARISON TO HEALTH CARE PRACTITIONERS IN ANOTHER
SPECIALTY AREA;

4. THERE ARE SIGNIFICANT INCREASES IN THE COST OF
PROVIDING HEALTH CARE SERVICES; OR

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