In this subtitle, “freestanding medical facility” means a facility:
In which medical and health services are provided;
That, except for a freestanding medical facility established as a result of a conversion of a licensed general hospital under § 19–120(o)(3) of this title, is physically separate from a hospital or hospital grounds;
That is an administrative part of a hospital, as defined in § 19–301 of this title; and
That meets the requirements for provider–based status under the certification for an affiliated hospital as set forth by the Centers for Medicare and Medicaid Services in 42 C.F.R. § 413.65.
On or before January 1, 2006, the Department shall adopt regulations for licensing a freestanding medical facility that uses in its title or advertising the word “emergency” or other language indicating to the public that medical treatment for immediately life-threatening medical conditions is available at that freestanding medical facility.
The regulations shall require the freestanding medical facility to:
Be open 24 hours a day, 7 days a week;
Have available at all times:
At least 1 physician who is credentialed in emergency medicine by the hospital of which the freestanding medical facility is an administrative part;
A sufficient number of registered nurses and other health care professionals to provide advanced life support;
Basic diagnostic and laboratory facilities and technicians;
Resuscitation supplies and equipment, including monitors, defibrillators, cardiac medications, intubation equipment, and intravenous line equipment;
A commercial ambulance for transport of individuals in need of hospitalization or other emergency care; and
Emergency services to all individuals, regardless of ability to pay;
Comply with all Maryland Institute for Emergency Medical Services Systems emergency transport protocols established for the freestanding medical facility;
Comply, except in a life–threatening emergency in which compliance is not feasible or practicable, with the federal Centers for Disease Control and Prevention guidelines on universal precautions; and
Display the notice developed under § 1–207 of the Health Occupations Article that explains the federal Centers for Disease Control and Prevention’s guidelines on universal precautions at the entrance to the freestanding medical facility;
Refrain from use of the words “emergency department”, “emergency room”, or “hospital”; and
Meet any other standard that the Secretary deems necessary to ensure the quality and safety of services provided by a freestanding medical facility.
The Department shall issue a license to a freestanding medical facility that:
Meets the licensure requirements under this subtitle; and
Receives a certificate of need or an exemption from obtaining a certificate of need from the Maryland Health Care Commission under § 19–120 of this title.
A freestanding medical facility that uses in its title or advertising the word “emergency” or other language indicating to the public that medical treatment for immediately life–threatening medical conditions exist at that facility shall be licensed by the Department before it may operate in this State.
Notwithstanding subsection (a)(2) of this section, the Department may not require a freestanding medical facility pilot project to be approved by the Maryland Health Care Commission as a condition of licensure.
The governing body of any county may adopt rules and regulations governing freestanding medical facilities more restrictive than the regulations adopted by the Department.
Except as provided in subsection (b) of this section, a person who violates any provision of this subtitle is guilty of a misdemeanor and on conviction is subject to a fine not exceeding $5,000 or imprisonment not exceeding 1 year or both.
In addition to other penalties available under law, the Department may impose sanctions against a freestanding medical facility that fails to comply with this subtitle or regulations adopted under this subtitle.
The sanctions imposed by the Department under paragraph (1) of this subsection include:
A civil penalty not to exceed $10,000;
Restrictions on the operation of the freestanding medical facility;
A directed plan of correction; and
Suspension or revocation of the freestanding medical facility’s license.
Except as otherwise provided under the Administrative Procedure Act, before the Department may impose sanctions under subsection (b)(2)(i), (ii), or (iv) of this section, the Department shall give the freestanding medical facility notice and the opportunity for a hearing and judicial review under the Administrative Procedure Act, as provided in Title 10, Subtitle 2 of the State Government Article.
Before the Department may impose a directed plan of correction, the Department shall give the freestanding medical facility notice and the opportunity for a prompt informal hearing with the Director of the Office of Health Care Quality.
The circuit court for a county in which a person is operating a freestanding medical facility in violation of a provision of this subtitle may enjoin further operation of the freestanding medical facility that violates this subtitle.
There are two freestanding medical facility pilot projects that shall operate in two jurisdictions in the State.
The Department shall issue a freestanding medical facility license to:
One freestanding medical facility pilot project if:
The freestanding medical facility pilot project is established by, and will operate administratively as part of, an acute care general hospital;
The acute care general hospital is part of a merged asset system with all of its existing Maryland acute care general hospitals located in a single jurisdiction;
There are not more than 5 acute care general hospitals in the jurisdiction;
One or more of the existing acute care general hospitals in the merged asset system has an emergency department volume of 75,000 or more visits for the 12 months ending June 30, 2004;
The freestanding medical facility pilot project will operate in Montgomery County;
The capital expenditure to implement the freestanding medical facility pilot project otherwise meets the requirements of § 19–120(k)(6)(viii) of this title; and
The freestanding medical facility pilot project meets the requirements under § 19–3A–02(b) of this subtitle; and
One freestanding medical facility pilot project if:
The freestanding medical facility pilot project is established by, and will operate administratively as part of, an acute care general hospital located in Talbot County;
The freestanding medical facility pilot project will operate in Queen Anne’s County;
The capital expenditure to implement the freestanding medical facility pilot project otherwise meets the requirements of § 19–120(k)(6)(viii) of this title; and
The freestanding medical facility pilot project meets the requirements under § 19–3A–02(b) of this subtitle.
A freestanding medical facility pilot project shall provide to the Maryland Health Care Commission information, as specified by the Commission, on the configuration, location, operation, and utilization, including patient–level utilization, of the pilot project.
A certificate of need is not required for a freestanding medical facility pilot project.
The provisions of §§ 19–3A–01 through 19–3A–06 of this subtitle shall apply to a freestanding medical facility pilot project.
This section applies to all payors subject to the rate–setting authority of the Health Services Cost Review Commission, including:
Insurers, nonprofit health service plans, and health maintenance organizations that deliver or issue for delivery individual, group, or blanket health insurance policies and contracts in the State;
Managed care organizations, as defined in § 15–101 of this article; and
The Maryland Medical Assistance Program established under Title 15, Subtitle 1 of this article.
A payor subject to this section shall pay rates set by the Health Services Cost Review Commission under Subtitle 2 of this title for hospital services provided at:
A freestanding medical facility pilot project authorized under this subtitle prior to January 1, 2008; and
A freestanding medical facility licensed under § 19–3A–03 of this subtitle.