Mid-Atlantic Health Law TOPICS

1. In June, the Maryland Department of Health and Mental Hygiene (DHMH) published proposed regulations that allow DHMH to obtain information regarding a management firm's past or current operation of a nursing home or related institution, including information about its financial/administrative ability to keep the facility in compliance with federal and state regulations. This additional information will be utilized when an applicant/licensee seeks DHMH's required approval for the facility's management firm.

2. In July, the Maryland Health Resources Planning Commission (MHRPC) formed a Technical Advisory Committee (TAC) on Merger and Consolidations to assist staff with the revision of the Acute Inpatient Services chapter of the State Health Plan (SHP), and related Certificate of Need regulations. Items for consideration include the examination of the statutory and SHP definition of a merger/consolidation, analysis of the regulatory barriers to mergers/consolidations and the development of incentives to encourage mergers that will reduce excess beds. Additionally, the TAC will make recommendations regarding the improvement of system efficiency through the development of integrated delivery networks. A final TAC report is expected in the fall.

3. In August, the HRPC published as proposed regulations a new cardiac surgery and therapeutic catheterization chapter of the State Health Plan. Included in the chapter are planning policies for cardiac services, threshold requirements for the docketing of new cardiac surgery applications and a revised need methodology. The only jurisdiction identified as needing a new cardiac surgery program is Western Maryland. Also, the HRPC published proposed regulatory changes that update the home health and hospice need projections to the Year 2001, and clarify the HRPC's Certificate of Need policies for each service. Limited home health need is projected for Montgomery, Anne Arundel, Baltimore and Harford counties, while additional hospice programs may be developed in Montgomery and Baltimore counties. Following public comment, the HRPC is scheduled to make a final determination on the proposed changes to all three services in November.

4. In September the Health Services Cost Review Commission (HSCRC) voted to remove 3.72% of system revenue from hospital rates for those hospitals seeking rate adjustments, retroactive to last April. The rate reduction has two components: 2.93% will be applied to all hospitals, while 0.79% will be levied on certain hospitals with "banked revenue that is, revenue that could have been earned from prior allowable rate increases that a hospital did not charge. The banking adjustment will be based solely on in-patient banked revenues. In addition to examining the banked revenue question, the HSCRC initiated a study to determine next year's hospital rate adjustment, if any Finally the HSCRC will investigate the factors that are driving the growth in the charges per Maryland hospital admission.