In this chapter, the following terms have the meanings indicated. Terms Defined. “Automated clearing house (ACH)”, as defined in COMAR 03.01.02.01B, means a central clearing organization that operates as a clearing house for transmitting or receiving entries between banks and bank accounts, and authorizes an electronic transfer of funds between banks or bank accounts. “Commission” means the Health Services Cost Review Commission. “Comptroller” means the Comptroller of the Treasury or the Comptroller's designee. “General Accounting Division” means the Fiscal Services Administration for the Maryland Department of Health. “Health Services Cost Review Commission Fund” means the special fund established under Health-General Article, §19-207.1(d), Annotated Code of Maryland. “Hospital” means an institution that is licensed by the Maryland Department of Health as an acute general hospital. “Hospital Uncompensated Care Fund” means the monies that are collected from hospitals for the equitable financing of hospital uncompensated care and which are a discrete part of the Health Services Cost Review Commission Fund. “Interest” means the investment earnings generated from the investment and reinvestment of the monies of the Hospital Uncompensated Care Fund which are separately held by the Treasury, accounted for by the Comptroller, and retained to the credit of the Health Services Cost Review Commission Fund. “Mark-up” means the mechanism used to increase hospital rates to allow for payer differentials, working capital (prompt payment) differentials, and a provision for uncompensated care. “Remittance” means the amount each hospital remits to the General Accounting Division pursuant to the predetermined formula established by the Commission to provide funding for the Commission's Hospital Uncompensated Care Fund. “Special rate adjustment” means an adjustment to a hospital's rates, which will bring the hospital's uncompensated care provision of its mark-up to the Statewide uncompensated care average. “Treasury” means the State Treasury. “Wire transfer” means an electronic transaction in which a hospital, through the hospital's bank and an automated clearing house, originates an entry crediting the Health Services Cost Review Commission Fund's bank account and debiting the hospital's bank account on the same day the transaction is initiated. The Commission shall make a special rate adjustment to the uncompensated care provision of each hospital's mark-up to pay for the financing of the reasonable costs of hospital uncompensated care. The Commission shall notify hospitals in writing of the amount due to be remitted in a given month before the first day of that month. On or before the first business day of each month, the Commission shall direct the General Accounting Division to arrange for the collection of the amount due to be remitted by individual hospitals. This amount shall be based on the difference between a hospital's uncompensated care provision in its mark-up and the Statewide uncompensated care average. The Commission shall, at the same time, notify the General Accounting Division in writing of the: Hospitals due to remit for that month; Amount of the remittance for that month; Hospitals to receive payments from the Hospital Uncompensated Care Fund for that month; Amount to be disbursed to hospitals from the Hospital Uncompensated Care Fund in that month; and The appropriate banking account information from each hospital in order to debit or disburse funds electronically by wire transfer. All funds collected shall be transferred to the Hospital Uncompensated Care Fund. By January 1, 2009, each hospital shall provide the Commission with sufficient banking information to facilitate the collection and disbursement of funds by the ACH or other wire transfer method. Each hospital shall initiate or authorize the ACH or other wire transfer method as directed by the Commission. On or before the 5th business day of each month, each hospital identified as due to remit monies in accordance with the provisions of these regulations shall make payment into the Hospital Uncompensated Care Fund in the manner prescribed by the Commission. On or before the 5th business day of each month, the Comptroller shall transfer monies out of the Hospital Uncompensated Care Fund and distribute monies to hospitals in the manner specified by the Commission. Funds generated through the special rate adjustment and the remittance due may only be used to finance the delivery of hospital uncompensated care. Interest earned from the monies collected shall be retained to the credit of the Hospital Uncompensated Care Fund. Interest earned may be used to pay for the reasonable expenses associated with implementation of the alternative methodology approved by the Commission for financing the reasonable costs of hospital uncompensated care. The Commission may impose penalties of up to 5 percent of the amount of an underpayment, unless an extension is granted as provided in §E of this regulation. A hospital that violates the provisions of Regulation .03 of this chapter shall, in addition to the penalties imposed under §A of this regulation, be subject to an annualized interest charge of 3 percentage points above the most recent average prime rate of interest, as published in the “Money Rates” section of the The Wall Street Journal, on the unpaid balance. In addition to the penalties the Commission may impose on a hospital that fails to pay the remittance in a timely manner, the Commission may refer the hospital's delinquent account to the Department of Budget and Fiscal Planning's Central Collection Unit pursuant to the procedures in State Finance and Procurement Article, Title 3, Subtitle 3, Annotated Code of Maryland. A hospital may file a written request with the Commission for a reasonable extension of time to make payment if the extension request is: Made in writing to the attention of the Executive Director; Supported by sufficient justification; and Made at a reasonable time before the due date of a required payment. The Executive Director shall respond promptly in writing to the requesting hospital upon receipt of the request by either approving or disapproving the request. Extensions will be granted only for valid reasons. Health-General Article, §§19-207, 19-207.1, 19-207.3, and 19-214, Annotated Code of Maryland Effective date: February 10, 1997 (24:3 Md. R. 188) Regulation .01 amended effective March 9, 1998 (25:5 Md. R. 369); May 31, 1999 (26:11 Md. R. 855) Regulation 01B amended as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); amended permanently effective March 9, 2009 (36:5 Md. R. 423) Regulation 02 amended as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); amended permanently effective March 9, 2009 (36:5 Md. R. 423) Regulation 03 amended as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); amended permanently effective March 9, 2009 (36:5 Md. R. 423) Regulation .04A, C amended effective March 9, 1998 (25:5 Md. R. 369); May 31, 1999 (26:11 Md. R. 855) Regulation 04A, C amended as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); amended permanently effective March 9, 2009 (36:5 Md. R. 423) Regulation .05 recodified to Regulation .06 and new Regulation .05 adopted effective March 9, 1998 (25:5 Md. R. 369) Regulation .05 amended effective May 31, 1999 (26:11 Md. R. 855) Regulation 05 repealed as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); repealed permanently effective March 9, 2009 (36:5 Md. R. 423) Regulation 06 amended as an emergency provision effective December 1, 2008 (36:2 Md. R. 97); amended permanently effective March 9, 2009 (36:5 Md. R. 423)