Mid-Atlantic Health Law TOPICS

1. In July, the Health Services Cost Review Commission (HSCRC) denied Union Memorial Hospital's request for a 3.89% rate increase as generated by the HSCRC's Inflation Adjustment System. In April, the HSCRC imposed a cap of 2.7% on hospital inflation adjustments. Union Memorial, the first hospital to make a case for an exception to the cap, cited its efficient performance compared to other hospitals statewide as a reason to grant the exception. However, the HSCRC maintained that Union Memorial's charge per admission had increased substantially over the national cost per adjusted admission over the last five years. HSCRC regulation currently allows hospitals to bank any revenue generated by the IAS over the 2.7% cap and to unbank the revenue in a future year.

2. Also in July, the HSCRC granted Peninsula Regional Medical Center (PRMC) a rate increase of .4%. The increase was the result of a settlement between PRMC and the HSCRC following a full rate request filed by the hospital in February. The hospital had requested a 4.30% rate increase while staff had proposed a 4.50% decrease to the hospital's rates. As a result of these negotiations, the HSCRC will revise some of its full rate review guidelines, including treatment of non-RVU cost centers, treatment of supplies and drugs, and the grouping of hospitals into particular peer groups for case mix adjustments. Additionally, the HSCRC recently released a list of potential performance criteria that will be used to identify hospitals for full rate reviews.

3. In July, the Health Care Access and Cost Commission (HCACC) approved a practice parameter for the management of pediatric asthma in the ambulatory setting. Since there is some opposition to the establishment of practice parameters as set forth in HCACC'S enabling legislation, HCACC's Advisory Committee on Practice Parameters (ACOPP) will not develop protocols for any additional medical specialties. Instead, the ACOPP will complete its work on its last two practice parameters - Management of Labor/Delivery and the Management of Acute Low Back Pain. HCACC's enabling statute states that any practice parameter adopted by HCACC cannot be used as evidence of the standard of care in a malpractice case.

4. In July, the Health Resources Planning Commission approved a new Chapter of the State Health Plan titled "Specialized Services - Organ Transplant Services" as a proposed permanent regulation. Public hearings on the proposed plan will be conducted in the Maryland and the Washington regions. Lynn S. Slawson