Mid-Atlantic Health Law TOPICS

1. In June, Maryland's highest court ruled that the Health Resources Planning Commission (HRPC) acted properly when it denied CON applications from Suburban Hospital and Holy Cross Hospital for two new open heart surgery programs. The State Health Plan requires a 200 case minimum to establish a new open heart surgery program, and the HRPC's 1993 need projections, the latest need projections published, showed a net need for only 90 cases for the Washington area. Although the HRPC's need projections were outdated, the court ruled that the projections remain in effect until new projections are published.

2. In September, the Health Care Access and Cost Commission released its second annual HMO report card, "Comparing the Quality of Maryland's HMOs: A Guide for Consumers." The report identifies 13 Maryland commercial HMOs, and rates each HMO on various aspects of health care including: access to care, referral to specialists, ease of making appointments, thoroughness of treatment, length of time to receive an appointment, and prenatal care.

3. In October, the HRPC approved a CON exemption request from University of Maryland Medical Center (UMMS) to close its 23-bed hospital-based subacute care unit at University Hospital in Baltimore City. This is the first request for the closure of a hospital-based subacute unit. UMMS based its closure decision on HCFA's declining reimbursement rates, effective July 1, 1998. Once delicensed, the 23 beds are not available for any other use. Patients needing subacute care will be directed to other sub-acute beds within the UMMS health network.

4. At its October retreat, the Health Services Cost Review Commission (HSCRC) agreed to lower Maryland's charge per inpatient hospital stay to 3% below the national average over the next three years. During this rate setting year, Maryland's charge per inpatient case has outpaced the nation. Some additional cost cutting mechanisms targeted by the HSCRC are modifications to the Inflation Adjustment System, changes to the way that hospitals can offset an assigned rate decrease, and the selection of high cost hospitals for an extensive review of the rates charged for each hospital service.