Mid-Atlantic Health Law TOPICS

1. In October, the Health Care Access and Cost Commission (HCACC) voted to recommend to the General Assembly the repeal of HCACC's obligation to develop and implement a uniform system of health care practitioner reimbursement. HCACC believes that competition, not regulation, will prevent the overpayment for health care services. However, HCACC will continue to monitor the cost of health care claims, and will pay particular attention to the unbundling of codes and "upcoding."

2. In October, HCACC released its first annual HMO Performance Report. The report is intended to provide a comparison of HMO health plans for Maryland consumers and businesses. Information included in the report is based on a survey of HMO members, and HCACC's application of measurement standards developed by the National Committee for Quality Assurance (NCQA). The report card scores 15 HMOs in five main categories: customer service, patient care, preventive care, care provided to sick patients and accreditation by NCQA.

3. In its 1997 Report to the Governor, released in November, the Health Resources Planning Commission (HRPC) calculates that there will be an excess of 4,400 to 5,500 acute care beds in Maryland by the year 2000. The report also notes a decrease in nursing home occupancies from 94% in 1992 to 92% in 1995. Also, from July, 1996 through June, 1997, the HRPC granted physicians over 40 Certificate of Need (CON) exemptions to open surgical or endoscopy suites in physician offices. Further, over 65% of the CON projects approved by the HRPC during the same timeframe were for new general home health agencies, while specialty home health and hospital subacute projects accounted for the next largest percentage-- 8.2% each.