Mid-Atlantic Health Law TOPICS

1. In July, the Health Resources Planning Commission (HRPC) ruled that a 1985 Certificate of Need (CON) exemption granted to Drs. Frankel and Dodd for an ambulatory surgery center in Prince George's County was no longer valid. New regulations, effective April 6, 1998, required holders of exemption letters for unbuilt ambulatory facilities issued before June 1, 1995, to notify the HRPC by May 6, 1998 of their good faith effort to develop the facility. Drs. Frankel and Dodd neglected to notify the HRPC on time and failed to submit other required semi-annual documentation.

 2. In August, the Health Services Cost Review Commission (HSCRC) refused to block CareFirst BlueCross BlueShield's attempt to negotiate with Maryland hospitals for lower hospital rates. CareFirst hopes to establish alternative rate arrangements whereby CareFirst would pay hospitals on a per case basis. Any alternative rate with a particular hospital, however, must still be approved by the HSCRC.

3. In August, the Health Care Cost and Access Commission (HCACC) unveiled a draft of its first practitioner specialty profile sheet, an ophthalmology profile, developed with the Maryland Society of Eye Physicians and Surgeons. Generally, the profile links the ages of HMO, indemnity and Medicare patients with their most commonly occurring diagnoses, and with the average allowed charges for those diagnoses. The Ophthalmology profile will be released to the public in September. The next specialties targeted for profiling are Optometry and Emergency Medicine.

4. Pursuant to legislation passed by the 1999 Maryland General Assembly, effective October 1, 1999, the HRPC and HCACC will merge. The consolidated regulatory agency will be called the Maryland Health Care Commission.