Mid-Atlantic Health Law TOPICS

1. The Centers for Medicare and Medicaid Services (CMS) has agreed to extend Maryland’s all-payer hospital rate setting system, administered by the Health Services Cost Review Commission, through 2019. The current five-year pilot was set to expire on December 31, 2018. The one-year extension will give CMS additional time to complete its review of Maryland’s proposal to extend the pilot for another five years.   

2. To increase price transparency in health care, the Maryland Health Care Commission (MHCC) has launched the initiative “Wear the Cost,” which aims to shed light on cost and quality differences among Maryland hospitals. As part of the new initiative, MHCC created the WearTheCost.org platform to educate health care consumers. Currently, the website allows consumers to compare cost and quality across Maryland hospitals for four procedures: (1) hip replacement, (2) knee replacement, (3) hysterectomy and (4) vaginal delivery. 

3. On July 1, 2017, the Institutions for Mental Disease (IMD) Exclusion Waiver went into effect in Maryland, expanding Medicaid reimbursement to include adult residential substance-use disorder treatment. As a result, individuals seeking care for mental diseases and chemical dependency disorders can now seek Medicaid-covered treatment in IMDs rather than general acute hospitals. Services provided pursuant to the waiver will be reimbursed through the Maryland Department of Health’s Administrative Service Organization, Beacon Health Options. Only certain levels of care will be reimbursable, and only providers who are properly licensed by the Office of Health Care Quality, and enrolled with Maryland Medicaid as provider type 54 (IMD Residential Substance-Use Disorder Facility for Adults) are eligible for reimbursement. 

4. The Maryland Department of Health Board of Examiners of Psychologists has amended the rules regarding licensing. Effective February 12, 2018, licensees and registrants who did not obtain a criminal history records check on initial licensure or registration will be required to obtain a check upon their first renewal of a license or registration after January 1, 2019. Licensees and registrants will also be required to obtain a check every six years following licensure or registration. The new rules also created an expedited licensure process for individuals licensed in another state returning to Maryland to practice.

Barry Rosen
(410) 576-4224 • brosen@gfrlaw.com