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<regulation prefix="Regulation" num=".05" citation="COMAR 10.37.10.05" title_num="10" subtitle_num="37" chapter_num="10" heading="Application for Temporary Change in Rates.">
  <paragraph num="A.">
    <text>The Commission may issue a general notice setting forth circumstances under which a hospital may obtain a temporary change in rates. The rates, if approved or modified, shall be effective before the rate review procedure set forth in these regulations, but not before the date of application.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A hospital may apply at any time for a temporary change in rates provided that one of the following conditions is satisfied:</text>
    <paragraph num="(1)">
      <text>A decline in the hospital's experienced or projected net revenues, due to factors beyond the hospital's control, requiring funds beyond those normally available;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>An increase in the hospital's experienced or projected expenses, due to factors beyond the hospital's control, requiring funds beyond those normally available; or</text>
    </paragraph>
    <paragraph num="(3)">
      <text>A hospital's expenses from regulated services exceed its revenues from regulated services, or the hospital's financial integrity is otherwise jeopardized (for example, for breaching its bond covenants).</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>The Commission and its staff shall review the application and consult with the hospital as to the necessity for the temporary change in rates and the amount of the change required. Designated interested parties shall have 6 working days from the filing of the application to submit comments to the Commission.</text>
  </paragraph>
  <paragraph num="D.">
    <text>Within 12 working days from the filing of the application, the Commission shall issue its order:</text>
    <paragraph num="(1)">
      <text>Denying the temporary change in rates and stating the grounds therefor; or</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Granting a temporary change in rates, stating:</text>
      <paragraph num="(a)">
        <text>The amount of the temporarily changed rates, which may or may not be the same as the rates set forth in the hospital's application;</text>
      </paragraph>
      <paragraph num="(b)">
        <text>The necessity for the temporary change in rates;</text>
      </paragraph>
      <paragraph num="(c)">
        <text>That a regular rate review proceeding on the proposed rates will be conducted by the Commission as soon as practicable;</text>
      </paragraph>
      <paragraph num="(d)">
        <text>The availability of copies of the order at the offices of the Commissioner; and</text>
      </paragraph>
      <paragraph num="(e)">
        <text>The availability of the record of the temporary rate application for inspection at the Commission's office during ordinary business hours.</text>
      </paragraph>
    </paragraph>
  </paragraph>
  <paragraph num="E.">
    <text>The Commission order denying or granting the temporary change in rates shall be published and copies forwarded to:</text>
    <paragraph num="(1)">
      <text>The hospital;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Designated interested parties; and</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Persons writing to the Commission requesting a copy of the order.</text>
    </paragraph>
  </paragraph>
  <paragraph num="F.">
    <text>In conducting an expedited review to establish a temporary rate for both inpatient and outpatient services, the Commission shall consider the hospital’s financial condition in addition to its relative efficiency and effectiveness in its performance under the Total Cost of Care Model. A temporary rate approved by the Commission may not result in regulated revenue exceeding regulated expenses in the most recently completed fiscal year.</text>
  </paragraph>
  <paragraph num="G.">
    <text>A temporary change in rates is subject to the Commission's final rate order in the regular rate review proceeding, which may be effective as of the date of the temporary rate order.</text>
  </paragraph>
</regulation>