WILLIAM DONALD SCHAEFER, Governor                                Ch. 9

5. COSTS IN A PARTICULAR HEALTH CARE SPECIALTY VARY
SIGNIFICANTLY FROM THE HEALTH CARE COST ANNUAL ADJUSTMENT GOAL
ESTABLISHED UNDER SUBSECTION (F) OF THIS SECTION.

(II)     IF THE COMMISSION DETERMINES THAT VOLUNTARY AND
COOPERATIVE EFFORTS BETWEEN THE COMMISSION AND APPROPRIATE HEALTH CARE
PRACTITIONERS HAVE BEEN UNSUCCESSFUL IN BRINGING THE APPROPRIATE HEALTH
CARE PRACTITIONERS INTO COMPLIANCE WITH THE HEALTH CARE COST GOALS OF THE
COMMISSION, THE COMMISSION MAY ADJUST THE CONVERSION MODIFIER.

(2) IF THE COMMISSION ADJUSTS THE CONVERSION MODIFIER UNDER THIS
SUBSECTION FOR A PARTICULAR SPECIALTY GROUP, A HEALTH CARE PRACTITIONER IN
THAT SPECIALTY GROUP MAY NOT BE REIMBURSED MORE THAN AN AMOUNT EQUAL TO
THE AMOUNT DETERMINED ACCORDING TO THE FACTORS SET FORTH IN SUBSECTION
(B)(3) (I) AND (II) OF THIS SECTION AND THE CONVERSION MODIFIER ESTABLISHED BY
THE COMMISSION.

(E) (1) ON AN ANNUAL BASIS, THE COMMISSION SHALL PUBLISH:

(I) THE TOTAL REIMBURSEMENT FOR ALL HEALTH CARE SERVICES
OVER A 12-MONTH PERIOD;

(II) THE TOTAL REIMBURSEMENT FOR EACH HEALTH CARE
SPECIALTY OVER A 12-MONTH PERIOD;

(III)    THE TOTAL REIMBURSEMENT FOR EACH C.P.T. CODE OVER A
12-MONTH PERIOD; AND

(IV)     THE ANNUAL RATE OF CHANGE IN REIMBURSEMENT FOR HEALTH
SERVICES BY HEALTH CARE SPECIALTIES AND BY C.P.T. CODE.

(2) IN ADDITION TO THE INFORMATION REQUIRED UNDER PARAGRAPH (1)
OF THIS SUBSECTION, THE COMMISSION MAY PUBLISH ANY OTHER INFORMATION THAT
THE COMMISSION DEEMS APPROPRIATE.

(F) THE COMMISSION MAY ESTABLISH HEALTH CARE COST ANNUAL
ADJUSTMENT GOALS FOR THE COST OF HEALTH CARE SERVICES AND MAY ESTABLISH
THE TOTAL COST OF HEALTH CARE SERVICES BY C.P.T. CODE TO BE RENDERED BY A
SPECIALTY GROUP OF HEALTH CARE PRACTITIONERS DESIGNATED BY THE COMMISSION
DURING A 12-MONTH PERIOD.

(G) IN DEVELOPING A HEALTH CARE COST ANNUAL ADJUSTMENT GOAL UNDER
SUBSECTION (F) OF THIS SECTION, THE COMMISSION SHALL:

(1) CONSULT WITH APPROPRIATE HEALTH CARE PRACTITIONERS, PAYORS,
THE MARYLAND HOSPITAL ASSOCIATION, THE HEALTH SERVICES COST REVIEW
COMMISSION, THE DEPARTMENT OF HEALTH AND MENTAL HYGIENE, AND THE
DEPARTMENT OF ECONOMIC AND EMPLOYMENT DEVELOPMENT; AND

(2) TAKE INTO CONSIDERATION:

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