2013 Maryland Code
HEALTH - GENERAL
§ 16-201 - Establishment of charges for services

§16-201.

(a) The Secretary shall adopt rules and regulations that set charges for services that the Department provides for the physically ill, aged, mentally disordered, intellectually disabled, and developmentally disabled and other recipients of services in or through State-operated:

(1) Clinics;

(2) Day care, day treatment, and day hospital care;

(3) Group homes and small residential homes;

(4) Inpatient care in regional and State hospitals and centers; and

(5) Inpatient and outpatient care of any other kind.

(b) The Secretary shall require political subdivisions and grantees to set, subject to approval and modifications of the Secretary, charges for services that are provided by the political subdivisions or grantees and that are supported wholly or partly by State or federal funds administered by the Department.

(c) Charges for services shall be set at least annually.

(d) If the Secretary considers it to be in the best interest of the public health, the Secretary may designate specific services for which a charge may not be made.

§ 16-201 - 1. Services and ability-to-pay schedule for local health agency prenatal and infant care services

(a) Assessment by Secretary. -- The Secretary shall make an assessment of the Department's health care services and ability-to-pay schedule for prenatal and infant care services offered through local health agencies.

(b) Information to be included in assessment. -- The assessment shall include the following:

(1) The availability of efficient health care services and providers;

(2) The identification of health care services that are not available;

(3) Access to health care;

(4) The need for specific health care;

(5) An evaluation of alternative means of providing health care services; and

(6) Financial and manpower resources required and available.

(c) Financial consultation; notification of right to obtain services. -- An applicant for services under this section shall receive:

(1) A personal financial consultation without charge to assess the applicant's ability to pay for health care offered through local health agencies; and

(2) Notification of the right to obtain services offered through local health agencies regardless of ability to pay.

(d) Regulations; uniform procedures; application of reduced rates. --

(1) The Secretary shall adopt regulations necessary to carry out the provisions of this section.

(2) Local health agencies shall implement uniform procedures to notify and consult potential prenatal and infant care services recipients.

(3) Reduced rates for recipients of services shall be applied fairly and uniformly, and according to the sliding fee scale developed by the Department.

§ 16-201 - 2. Cost-of-living adjustment [Amendment subject to abrogation].

(a) Definitions. --

(1) In this section the following words have the meanings indicated.

(2) "Community developmental disabilities services provider" means a community-based developmental disabilities program licensed by the Department.

(3) "Community mental health services provider" means a community-based mental health program approved by the Department or an individual practitioner who contracts with the Department or the appropriate core service agency.

(4) "Core service agency" has the meaning stated in § 10-1201 of this article.

(5) "Eligible individual" means a Medicaid recipient or an individual who receives developmental disabilities services or mental health services subsidized in whole or in part by the State.

(b) Reimbursement for approved services. -- Notwithstanding the provisions of this subtitle, the Department shall reimburse a community developmental disabilities services provider or a community mental health services provider for approved services rendered to an eligible individual as provided in this section.

(c) Factors used for adjustment. --

(1) Beginning in fiscal year 2012 and in each fiscal year thereafter, the Department shall adjust for inflation the fees paid to a community developmental disabilities services provider and a community mental health services provider for approved services rendered to an eligible individual.

(2) The Department shall establish an annual inflationary cost adjustment for providers that shall be aligned with the annual cost adjustments for units of State government in the Governor's proposed budget.

(3) Subject to paragraphs (4) and (5) of this subsection, the Department shall ensure that the annual inflationary cost adjustment for providers is equivalent to the annual inflationary cost adjustments for categories of costs for units of State government in the Governor's proposed budget by using the weighted average cost structure set forth in § 13-806(b)(1) of this article.

(4) The annual inflationary cost adjustments for categories of costs for units of State government used to establish the annual inflationary cost adjustment for providers may not be less than 0%.

(5) The annual inflationary cost adjustment for providers may not exceed a maximum adjustment of 4%.

(6) Annual adjustments shall be funded with due regard to the expenditures necessary to meet the needs of individuals receiving services.

§ 16-201 - 2. Cost-of-living adjustment. (Abrogation of amendment effective June 30, 2016.)

(a) Definitions. --

(1) In this section the following words have the meanings indicated.

(2) "Community developmental disabilities services provider" means a community-based developmental disabilities program licensed by the Department.

(3) "Community mental health services provider" means a community-based mental health program approved by the Department or an individual practitioner who contracts with the Department or the appropriate core service agency.

(4) "Core service agency" has the meaning stated in § 10-1201 of this article.

(5) "Eligible individual" means a Medicaid recipient or an individual who receives developmental disabilities services or mental health services subsidized in whole or in part by the State.

(b) Reimbursement for approved services. -- Notwithstanding the provisions of this subtitle, the Department shall reimburse a community developmental disabilities services provider or a community mental health services provider for approved services rendered to an eligible individual as provided in this section.

(c) Factors used for adjustment. --

(1) Subject to the limitations of the State budget, beginning in fiscal year 2008 and in each fiscal year thereafter, the Department shall adjust for inflation the fees paid to a community developmental disabilities services provider and a community mental health services provider for approved services rendered to an eligible individual using the update factor recommended by the Community Services Reimbursement Rate Commission.

(2) Annual adjustments shall be funded with due regard to the expenditures necessary to meet the needs of individuals receiving services.

(3) The annual rate of change for the fees may not exceed a maximum rate of 5%.