Mid-Atlantic Health Law TOPICS

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Maryland Regulatory News Summer 2008

1. The Governor appointed Herbert S. Wong, Ph.D. to the Health Services Cost Review Commission (HSCRC). Commissioner Wong is a Senior Economist at the Agency for Healthcare Research and Quality in Rockville, MD.  His research interests include hospital efficiency measurement, the role of quality in the hospital services market and the study of the factors that affect physician practice styles and resource utilization. He replaces Commissioner William H. Munn. 
2. In April, the HSCRC announced a delay in the implementation of the new Ambulatory Surgery Guaranteed Outpatient Revenue (GOR) payment system, because of a delay in obtaining needed data. While the HSCRC had hoped to implement the GOR during the year beginning July 1, 2007 with respect to outpatient surgery, the GOR will now be implemented beginning on July 1, 2008, and emergency department and clinic service are anticipated to be included in the charge per visit target. As a result of the foregoing, the year ending June 30, 2008, instead of June 30, 2007, will be used as the base year for the GOR. 
3. In April, the Maryland Health Care Commission (HCC) approved a certificate of need (CON) for the first GREEN HOUSE(r) comprehensive care facility in Maryland. It will be located at Stadium Place in Baltimore City. The Green House design provides care in smaller, home-like residential-looking areas for 8-10 residents and features access to outdoor spaces. Each resident has a private room with bath, and all rooms are arranged around a central family-style kitchen, dining and living area. A group of Green Houses together form the nursing home. The atmosphere is non-medical, with emphasis on more autonomy for both residents and staff. Each house has certified nursing assistants on site who receive extra training in engaging residents in activities, doing personal care and helping with meals. The 49-bed Green House facility expects to serve medically complex residents, and is sponsored by the Govans Ecumenical Development Corporation. The facility's cost is $12,406,466, and is projected to be funded by State/local grants and donations. 
4. By December 31, 2008, the HCC and the Office on Health Care Quality will draft a report for the consideration of the General Assembly  in regard to a regulatory scheme that could replace the CON requirement for home health agencies. Some changes that will be considered are changes in the licensure application process to assure an applicant's fiscal solvency and administrative competence.  Additional questions surround commitments to charity care and quality measures, and whether licenses should be restricted to specific jurisdictions. The agencies also will address the process for delicensing agencies providing poor quality service. It is likely that the new regulatory strategy will recommend a transition phase that will phase in new licensees over a period of years for gradual growth, as well as a fully-implemented phase.


June 21, 2008




Rosen, Barry F.


Health Care