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<section article="ghg" article_name="Health - General" number="19-143" 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>On or before October 1, 2009, the Commission and the Health Services Cost Review Commission shall designate a health information exchange for the State.</text>
    </level>
    <level label="2">
      <text>The Secretary, to align funding opportunities with the purposes of this section and the development and effective operation of the State–designated health information exchange, may provide grants to the State–designated health information exchange.</text>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>On or before September 1, 2011, the Commission, in consultation with the Department, payors, and health care providers, shall adopt regulations that require State–regulated payors to provide incentives to health care providers to promote the adoption and meaningful use of electronic health records.</text>
    </level>
    <level label="2">
      <text>Incentives required under the regulations:</text>
      <level label="i">
        <text>Shall have monetary value;</text>
      </level>
      <level label="ii">
        <text>Shall facilitate the use of electronic health records by health care providers in the State;</text>
      </level>
      <level label="iii">
        <text>To the extent feasible, shall recognize and be consistent with existing payor incentives that promote the adoption and meaningful use of electronic health records;</text>
      </level>
      <level label="iv">
        <text>Shall take into account:</text>
        <level label="1">
          <text>Incentives provided to health care providers under Medicare and Medicaid; and</text>
        </level>
        <level label="2">
          <text>Any grants or loans that are available to health care providers from the federal government;</text>
        </level>
      </level>
      <level label="v">
        <text>May include:</text>
        <level label="1">
          <text>Increased reimbursement for specific services;</text>
        </level>
        <level label="2">
          <text>Lump sum payments;</text>
        </level>
        <level label="3">
          <text>Gain–sharing arrangements;</text>
        </level>
        <level label="4">
          <text>Rewards for quality and efficiency;</text>
        </level>
        <level label="5">
          <text>In–kind payments; and</text>
        </level>
        <level label="6">
          <text>Other items or services to which a specific monetary value can be assigned; and</text>
        </level>
      </level>
      <level label="vi">
        <text>Shall be paid in cash, unless the State–regulated payor and the health care provider agree on an incentive of equivalent value.</text>
      </level>
    </level>
    <level label="3">
      <text>The regulations need not require incentives for the adoption and meaningful use of electronic health records for each type of health care provider listed in § 19–142(e) of this subtitle.</text>
    </level>
    <level label="4">
      <text>If federal law is amended to allow the State to regulate payments made by entities that self–insure their health benefit plans, regulations adopted under this section shall apply to those entities to the same extent to which they apply to State–regulated payors.</text>
    </level>
    <level label="5">
      <text>Regulations adopted under this subsection:</text>
      <level label="i">
        <text>May not require a group model health maintenance organization, as defined in § 19–713.6 of this title, to provide an incentive to a health care provider who is employed by the multispecialty group of physicians under contract with the group model health maintenance organization; and</text>
      </level>
      <level label="ii">
        <text>Shall allow a State–regulated payor to:</text>
        <level label="1">
          <text>Request information from a health care provider to validate the health care provider’s incentive claim; and</text>
        </level>
        <level label="2">
          <text>If the State–regulated payor determines that a duplicate incentive payment or an overpayment has been made, reduce the incentive amount.</text>
        </level>
      </level>
    </level>
    <level label="6">
      <text>The Commission may:</text>
      <level label="i">
        <text>Audit the State–regulated payor or the health care provider for compliance with the regulations adopted under this subsection; and</text>
      </level>
      <level label="ii">
        <text>If it finds noncompliance, request corrective action.</text>
      </level>
    </level>
    <level label="7">
      <text>It is the intent of the General Assembly that the State Employee and Retiree Health and Welfare Benefits Program support the incentives provided under this subsection through contracts between the Program and the third party administrators arranging for the delivery of health care services to members covered under the Program.</text>
    </level>
  </level>
  <level label="c">
    <text>The Health Services Cost Review Commission, in consultation with hospitals, payors, and the federal Centers for Medicare and Medicaid Services, shall take the actions necessary to:</text>
    <level label="1">
      <text>Assure that hospitals in the State receive the payments provided under § 4102 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations; and</text>
    </level>
    <level label="2">
      <text>Implement any changes in hospital rates required by the federal Centers for Medicare and Medicaid Services to ensure compliance with § 4102 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations.</text>
    </level>
  </level>
  <level label="d">
    <text>The Department, in consultation with the Commission, shall develop a mechanism to assure that health care providers that participate in the Maryland Medical Assistance Program receive the payments provided for adoption and use of electronic health records technology under § 4201 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations.</text>
  </level>
  <level label="e">
    <level label="1">
      <text>On or before October 1, 2012, the Commission shall designate one or more management service organizations to offer services throughout the State.</text>
    </level>
    <level label="2">
      <text>The Commission may use federal grants and loans to help subsidize the use of the designated management service organizations by health care providers.</text>
    </level>
  </level>
  <level label="f">
    <text>On and after the later of January 1, 2015, or the date established for the imposition of penalties under § 4102 of the federal American Recovery and Reinvestment Act of 2009:</text>
    <level label="1">
      <text>Each health care provider using an electronic health record that seeks payment from a State–regulated payor shall use electronic health records that are:</text>
      <level label="i">
        <text>Certified by a national certification organization designated by the Commission; and</text>
      </level>
      <level label="ii">
        <text>Capable of connecting to and exchanging data with the State–designated health information exchange; and</text>
      </level>
    </level>
    <level label="2">
      <text>The incentives required under subsection (b) of this section may include reductions in payments to a health care provider that does not use electronic health records that meet the requirements of paragraph (1) of this subsection.</text>
    </level>
  </level>
</section>
