# COMAR Title 10 — Maryland Department of Health

## Subtitle 37 — Health Services Cost Review Commission

### Chapter 03 — Types and Classes of Charges Which Cannot Be Changed Without Prior Commission Approval

#### Regulation .09 Rates for Non-Physician Services Provided to Hospital Inpatients by Third-Party Contractors.

*COMAR 10.37.03.09*

A. A non-physician inpatient service is defined as a hospital service under the jurisdiction of the Commission provided by a third-party contractor to a hospital inpatient off-site of the hospital. The charge for this service shall be billed by the hospital.

B. The allowable rate shall be equal to or less than the Statewide median or price standard as developed by staff.

C. The same rate on average shall be charged to all inpatients, regardless of payor.

D. The sum of the rate charged to a hospital inpatient and the professional component, if any, on average, shall be not greater than that charged on average by the third-party contractor to its other patients for the sum of both components of the same service.

E. The hospital shall provide an audit by an independent CPA that the contractor is in compliance with Sec. D of this regulation.

F. The hospital shall be at risk for any payment made to a contractor in excess of the allowable charge determined in accordance with Sec. B of this regulation.

G. The Commission shall waive COMAR 10.37.10.07A, which requires a rate application be filed at least 60 days before the opening of a new service, for rate applications approved under this regulation.

H. The sections of this regulation are nonseverable and the entire regulation shall be null and void 60 days after a Court of competent jurisdiction rules that any portion or section of this regulation is beyond the jurisdiction of the Commission.