Mid-Atlantic Health Law TOPICS

1. In May, the Maryland Health Care Commission (MHCC) released its report, "Practitioner Expenditures and Utilization: Experience from 1998," that analyzed the health care services provided by practitioners to 2.5 million Marylanders. From 1997 to 1998, spending on physician services grew 7.7%, while expenditures for non-physician providers grew by 4.4%. The state's total health care expenditures increased by 5.3% in 1998. Non-HMO recipients paid an average of $818 and received an average 9.85 work relative value units (RVUs) of practitioner services, compared to an average total payment of $581 and 7.61 work RVUs for HMO recipients. Overall, utilization was higher for private non-HMOs, but spending on specialty care physicians was approximately the same, $340 per recipient.
2. In June, the MHCC released the "1999 Maryland Ambulatory Surgery Provider Directory" that gives specific information on Maryland's 268 hospital-based and freestanding providers. The directory includes a provider's location, accreditation/certification specialty, number of operating/procedure rooms and number of cases performed during 1998. In 1998, there was a 9% increase in cases reported by all ambulatory surgery facilities, and an overall increase of 12% in ambulatory surgical capacity. While single specialty facility capacity remained stable from 1997 to 1998, operating capacity increased by 22% in multi-specialty facilities, and increased by 14% in hospital-based ambulatory surgery facilities.
3. In July, the Health Services Cost Review Commission (HSCRC) approved emergency regulations that place a moratorium on hospitals filing full rate review applications with the HSCRC. The moratorium will last until January 1, 2001. During this time, staff will revise the Interhospital Cost Comparison (ICC), the special methodology used to evaluate a hospital's full rate application, to make the ICC compatible with the redesigned hospital rate system.
4. In 1999, the General Assembly directed the MHCC to develop priorities, a work plan and a process for reviewing major policy issues related to the certificate of need (CON) process during 2000 and 2001. The MHCC initiated its CON study by issuing a series of working papers that discuss options for government oversight of specific health care services. The services scheduled for review during 2000 are: acute inpatient obstetric services, cardiac surgery services, home health and hospital services and comprehensive care (nursing home) services. Slated for study in 2001 are: specialized hospital services (including NICU, organ transplant surgery, burn treatment, and comprehensive inpatient rehabilitation), general hospital services (including pediatrics and acute psychiatry), ambulatory surgical services, residential treatment centers and mental health and substance abuse services. MHCC will solicit public comment on all its working papers. The MHCC's recommendations on the services studied this year will go to the General Assembly in January 2001.

Lynn S. Slawson
(410) 576-4116 • Islawson@gfrlaw.com