<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".05" citation="COMAR 10.37.03.05" title_num="10" subtitle_num="37" chapter_num="03" heading="Overcharges and Undercharges by Hospitals.">
  <paragraph num="A.">
    <text>For purposes of this regulation, the following definitions apply:</text>
    <paragraph num="(1)">
      <text>“Overcharge” means any charge for a hospital service under the jurisdiction of the Commission that is in excess of its approved rate.</text>
    </paragraph>
    <paragraph num="(2)">
      <text>“Undercharge” means any charge for a hospital service under the jurisdiction of the Commission that is less than its approved rate.</text>
    </paragraph>
  </paragraph>
  <paragraph num="B.">
    <text>When any hospital overcharges by more than the allowed corridors, as defined in §G of this regulation, that overcharge shall be recovered in prospective rates at 140 percent plus appropriate interest factors.</text>
  </paragraph>
  <paragraph num="C.">
    <text>When any hospital overcharges less than the allowed corridor, as defined in §G of this regulation, that overcharge shall be reduced from prospectively approved rates at the actual amount of overcharge plus appropriate interest.</text>
  </paragraph>
  <paragraph num="D.">
    <text>When any hospital undercharges more than 2 percent in obstetrics, nursery, labor and delivery, clinic, emergency room, pediatrics, or intensive care units, that undercharge may not be recovered in prospective periods.</text>
  </paragraph>
  <paragraph num="E.">
    <text>When any hospital undercharges less than 2 percent in the patient service centers listed in §D of this regulation, that undercharge shall be added to prospectively approved rates at the actual amount of undercharges.</text>
  </paragraph>
  <paragraph num="F.">
    <text>When a hospital undercharges beyond the allowed corridors, as defined in this section, the amount of undercharge in excess of the corridors less 40 percent shall be added to prospectively approved rates. These allowed undercharge corridors are defined as follows:</text>
    <paragraph num="(1)">
      <text>Patient care areas, when the unit of service is</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Admissions center ---------------------------------- 3 percent;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Ancillary service areas and ambulatory service</text>
    </paragraph>
  </paragraph>
  <paragraph num="G.">
    <text>Overcharge Corridors and Pricing for Medical/Surgical Supplies and Drugs.</text>
    <paragraph num="(1)">
      <text>The allowed overcharge corridors are defined as follows:</text>
      <paragraph num="(a)">
        <text>Daily patient care areas, ambulatory</text>
      </paragraph>
      <paragraph num="(b)">
        <text>Labor and delivery room -------------------------- 3 percent;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>Renal dialysis ----------------------------------- 5 percent;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>Ancillary service areas other than labor and</text>
      </paragraph>
    </paragraph>
    <paragraph num="(2)">
      <text>There are no price corridors for medical/surgical supplies and drugs.</text>
    </paragraph>
  </paragraph>
  <paragraph num="H.">
    <text>Notwithstanding this regulation, if any hospital's net overcharges are more than 1 percent of the hospital's total approved revenue, that overcharge shall be recovered in prospective rates at 140 percent plus appropriate interest factors.</text>
  </paragraph>
  <paragraph num="I.">
    <text>In cases when a flagrant disregard of approved rates is found, the Commission may require direct repayment of overcharges and penalties to those patients who were overcharged.</text>
  </paragraph>
  <paragraph num="J.">
    <text>The Commission may assess penalties as described in this regulation, for rates approved effective July 1, 1978.</text>
  </paragraph>
</regulation>