PROPOSAL
Maryland Register
Issue Date: September 14, 2018
Volume 45 • Issue 19 • Pages 878—879
Title 10
MARYLAND DEPARTMENT OF HEALTH
Subtitle 09 MEDICAL CARE PROGRAMS
10.09.95 Special Psychiatric Hospitals
Authority: Health-General Article, §§2-104(b), 15-102.8, 15-103, and 15-105, Annotated Code of Maryland
Notice of Proposed Action
[18-233-P]
The Secretary of Health proposes to amend Regulation .07 under COMAR 10.09.95 Special Psychiatric Hospitals.
Statement of Purpose
The purpose of this action is to align the payment methodology for out-of-State psychiatric hospitals with the payment methodology for other out-of-State hospitals by reimbursing them the lesser of its charges or the amount reimbursable by the host state’s Title XIX agency.
Comparison to Federal Standards
There is no corresponding federal standard to this proposed action.
Estimate of Economic Impact
I. Summary of Economic Impact. The economic impact of the proposed amendment is indeterminable, but is likely to result in some cost savings.
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Revenue (R+/R-) |
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II. Types of Economic Impact. |
Expenditure (E+/E-) |
Magnitude |
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A. On issuing agency: |
(E-) |
Indeterminable |
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B. On other State agencies: |
NONE |
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C. On local governments: |
NONE |
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Benefit (+)
Cost (-) |
Magnitude |
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D. On regulated industries or trade groups: |
NONE |
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E. On other industries or trade groups: |
(-) |
Indeterminable |
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F. Direct and indirect effects on public: |
NONE |
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III. Assumptions. (Identified by Impact Letter and Number from Section II.) |
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A. Under the current regulations, out-of-State facilities are cost settled in accordance with Medicare principles. The economic impact of the proposed amendment is indeterminable because the host state rates are not known, and these services are infrequently utilized. However, it is unlikely that a host state's Medicaid rate in its State Plan would exceed costs under Medicare principles, therefore the amendment is likely to result in some amount of savings to the State. |
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E. Under the current regulations, out-of-State facilities are cost settled in accordance with Medicare principles. The economic impact of the proposed amendment is indeterminable because the host state rates are not known, and these services are infrequently utilized. However, it is unlikely that a host state's Medicaid rate in its State Plan would exceed costs under Medicare principles, therefore the amendment is likely to result in some amount of decreased revenue to the host state. |
Economic Impact on Small Businesses
The proposed action has minimal or no economic impact on small businesses.
Impact on Individuals with Disabilities
The proposed action has no impact on individuals with disabilities.
Opportunity for Public Comment
Comments may be sent to Michele Phinney, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 W. Preston Street, Room 512, Baltimore, MD 21201, or call 410-767-6499 (TTY 800-735-2258), or email to mdh.regs@maryland.gov, or fax to 410-767-6483. Comments will be accepted through October 15, 2018. A public hearing has not been scheduled.
.07 Payment Procedures.
A. Reimbursement Principles.
(1)—(7) (text unchanged)
(8) Inpatient and outpatient services in [out-of-State or] District of Columbia special psychiatric and outpatient services in in-State special psychiatric hospitals are cost-settled on an annual basis according to §B of this regulation.
(9) Effective October 1, 2018, an out-of-State special psychiatric hospital shall be reimbursed the lesser of its charges or the amount reimbursable by the host state’s Title XIX agency.
(10) An out-of-State provider shall submit proof of host state rates on an annual basis.
B.—M. (text unchanged)
ROBERT R. NEALL
Secretary of Health
