<?xml version='1.0' encoding='utf-8'?>
<section article="ghg" article_name="Health - General" number="19-111" title_number="19" title_name="Health Care Facilities" subtitle_number="1" subtitle_name="Health Care Planning and Systems Regulation">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Fund” means the Maryland Health Care Commission Fund.</text>
    </level>
    <level label="3">
      <text>“Health benefit plan” has the meaning stated in § 15–1201 of the Insurance Article.</text>
    </level>
    <level label="4">
      <text>“Health care practitioner” means any individual who is licensed, certified, or otherwise authorized under the Health Occupations Article to provide health care services.</text>
    </level>
    <level label="5">
      <text>“Nursing home” means a related institution that is classified as a nursing home.</text>
    </level>
    <level label="6">
      <text>“Payor” means:</text>
      <level label="i">
        <text>A health insurer or nonprofit health service plan that holds a certificate of authority and provides health insurance policies or contracts in the State in accordance with this article or the Insurance Article; or</text>
      </level>
      <level label="ii">
        <text>A health maintenance organization that holds a certificate of authority in the State.</text>
      </level>
    </level>
  </level>
  <level label="b">
    <text>Subject to the provisions of subsection (d) of this section, the Commission shall assess a fee on:</text>
    <level label="1">
      <text>All hospitals;</text>
    </level>
    <level label="2">
      <text>All nursing homes;</text>
    </level>
    <level label="3">
      <text>All payors; and</text>
    </level>
    <level label="4">
      <text>All health care practitioners.</text>
    </level>
  </level>
  <level label="c">
    <level label="1">
      <text>The total fees assessed by the Commission may not exceed $20,000,000.</text>
    </level>
    <level label="2">
      <level label="i">
        <text>The fees assessed by the Commission shall be used exclusively to cover the actual documented direct costs of fulfilling the statutory and regulatory duties of the Commission in accordance with the provisions of this subtitle.</text>
      </level>
      <level label="ii">
        <text>The costs of the Commission include the administrative costs incurred by the Department on behalf of the Commission.</text>
      </level>
      <level label="iii">
        <text>The amount to be paid by the Commission to the Department for administrative costs, not to exceed 30.5% of the salaries of the Commission, shall be based on indirect costs or services benefiting the Commission, less overhead costs paid directly by the Commission.</text>
      </level>
    </level>
    <level label="3">
      <text>The Commission shall pay all funds collected from the fees assessed in accordance with this section into the Fund.</text>
    </level>
    <level label="4">
      <text>The fees assessed may be expended only for purposes authorized by the provisions of this subtitle.</text>
    </level>
    <level label="5">
      <text>The amount in paragraph (1) of this subsection limits only the total fees the Commission may assess in a fiscal year.</text>
    </level>
  </level>
  <level label="d">
    <text>In determining assessments of the total fees, the Commission shall:</text>
    <level label="1">
      <text>Use a methodology that accounts for the portion of the Commission’s workload attributable to each industry assessed; and</text>
    </level>
    <level label="2">
      <text>Recalculate workload distribution every 4 years.</text>
    </level>
  </level>
  <level label="e">
    <level label="1">
      <text>The fees assessed in accordance with this section on health care practitioners shall be:</text>
      <level label="i">
        <text>Included in the licensing fee paid to the health care practitioner’s licensing board; and</text>
      </level>
      <level label="ii">
        <text>Transferred by the health care practitioner’s licensing board to the Commission on a quarterly basis.</text>
      </level>
    </level>
    <level label="2">
      <text>The Commission may adopt regulations that waive the fee assessed under this section for a specific class of health care practitioners.</text>
    </level>
    <level label="3">
      <level label="i">
        <text>Subject to subparagraph (ii) of this paragraph, the Commission shall adopt regulations to permit a waiver of the fee assessment requirements for certain health care practitioners.</text>
      </level>
      <level label="ii">
        <text>In adopting regulations to permit a waiver of the fee assessment requirements for certain health care practitioners, the Commission shall:</text>
        <level label="1">
          <text>Consider the hourly wages of the health care practitioners; and</text>
        </level>
        <level label="2">
          <text>Give preference to exempting health care practitioners with an average hourly wage substantially below that of other health care practitioners.</text>
        </level>
      </level>
    </level>
  </level>
  <level label="f">
    <level label="1">
      <text>There is a Maryland Health Care Commission Fund.</text>
    </level>
    <level label="2">
      <text>The Fund is a special continuing, nonlapsing fund that is not subject to § 7–302 of the State Finance and Procurement Article.</text>
    </level>
    <level label="3">
      <text>The Treasurer shall separately hold, and the Comptroller shall account for, the Fund.</text>
    </level>
    <level label="4">
      <text>The Fund shall be invested and reinvested in the same manner as other State funds.</text>
    </level>
    <level label="5">
      <text>Any investment earnings shall be retained to the credit of the Fund.</text>
    </level>
    <level label="6">
      <text>The Fund shall be subject to an audit by the Office of Legislative Audits as provided for in § 2–1220 of the State Government Article.</text>
    </level>
    <level label="7">
      <text>This section may not be construed to prohibit the Fund from receiving funds from any other source.</text>
    </level>
    <level label="8">
      <text>The Fund shall be used only to provide funding for the Commission and for the purposes authorized under this subtitle.</text>
    </level>
  </level>
  <level label="g">
    <text>The Commission shall:</text>
    <level label="1">
      <level label="i">
        <text>Assess fees on payors in a manner that apportions the total amount of the fees to be assessed on payors under subsection (d)(1) of this section among each payor based on the ratio of each payor’s total premiums written in the State for health benefit plans to the total written premiums of all payors written in the State; and</text>
      </level>
      <level label="ii">
        <text>On or before June 30 of each year, assess each payor a fee in accordance with item (i) of this item;</text>
      </level>
    </level>
    <level label="2">
      <level label="i">
        <text>Assess fees for each hospital equal to the sum of:</text>
        <level label="1">
          <text>The amount equal to one–half of the total fees to be assessed on hospitals under subsection (d)(1) of this section times the ratio of admissions of the hospital to total admissions of all hospitals; and</text>
        </level>
        <level label="2">
          <text>The amount equal to one–half of the total fees to be assessed on hospitals under subsection (d)(1) of this section times the ratio of gross operating revenue of each hospital to total gross operating revenues of all hospitals;</text>
        </level>
      </level>
      <level label="ii">
        <text>Establish minimum and maximum assessments; and</text>
      </level>
      <level label="iii">
        <text>On or before June 30 of each year, assess each hospital a fee in accordance with item (i) of this item; and</text>
      </level>
    </level>
    <level label="3">
      <level label="i">
        <text>Assess fees for each nursing home equal to the sum of:</text>
        <level label="1">
          <text>The amount equal to one–half of the total fees to be assessed on nursing homes under subsection (d)(1) of this section times the ratio of admissions of the nursing home to total admissions of all nursing homes; and</text>
        </level>
        <level label="2">
          <text>The amount equal to one–half of the total fees to be assessed on nursing homes under subsection (d)(1) of this section times the ratio of gross operating revenue of each nursing home to total gross operating revenues of all nursing homes;</text>
        </level>
      </level>
      <level label="ii">
        <text>Establish minimum and maximum assessments; and</text>
      </level>
      <level label="iii">
        <text>On or before June 30 of each year, assess each nursing home a fee in accordance with item (i) of this item.</text>
      </level>
    </level>
  </level>
  <level label="h">
    <level label="1">
      <text>On or before September 1 of each year, each payor, hospital, and nursing home assessed under this section shall make payment to the Commission.</text>
    </level>
    <level label="2">
      <text>The Commission shall make provisions for partial payments.</text>
    </level>
  </level>
  <level label="i">
    <text>Any bill not paid within 30 days of the payment due date may be subject to an interest penalty to be determined and collected by the Commission.</text>
  </level>
</section>
