4. There are significant increases in the cost of providing
health care services; or

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 code over a 12-month period;

and

(iv) The annual rate of change in reimbursement for health services
by health care specialties and by 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 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] ASSOCIATION OF MARYLAND HOSPITALS AND
HEALTH SYSTEMS, the Health Services Cost Review Commission, the Department of
Health and Mental Hygiene, and the Department of Business and Economic
Development; and

(2) Take into consideration: