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Statutes Text

Article - Health - General




§19–143.

    (a)    (1)    On or before October 1, 2009, the Commission and the Health Services Cost Review Commission shall designate a health information exchange for the State.

        (2)    The Secretary, to align funding opportunities with the purposes of this section and the development and effective operation of the State–designated health information exchange, may provide grants to the State–designated health information exchange.

    (b)    (1)    On or before September 1, 2011, the Commission, in consultation with the Department, payors, and health care providers, shall adopt regulations that require State–regulated payors to provide incentives to health care providers to promote the adoption and meaningful use of electronic health records.

        (2)    Incentives required under the regulations:

            (i)    Shall have monetary value;

            (ii)    Shall facilitate the use of electronic health records by health care providers in the State;

            (iii)    To the extent feasible, shall recognize and be consistent with existing payor incentives that promote the adoption and meaningful use of electronic health records;

            (iv)    Shall take into account:

                1.    Incentives provided to health care providers under Medicare and Medicaid; and

                2.    Any grants or loans that are available to health care providers from the federal government;

            (v)    May include:

                1.    Increased reimbursement for specific services;

                2.    Lump sum payments;

                3.    Gain–sharing arrangements;

                4.    Rewards for quality and efficiency;

                5.    In–kind payments; and

                6.    Other items or services to which a specific monetary value can be assigned; and

            (vi)    Shall be paid in cash, unless the State–regulated payor and the health care provider agree on an incentive of equivalent value.

        (3)    The regulations need not require incentives for the adoption and meaningful use of electronic health records for each type of health care provider listed in § 19–142(e) of this subtitle.

        (4)    If federal law is amended to allow the State to regulate payments made by entities that self–insure their health benefit plans, regulations adopted under this section shall apply to those entities to the same extent to which they apply to State–regulated payors.

        (5)    Regulations adopted under this subsection:

            (i)    May not require a group model health maintenance organization, as defined in § 19–713.6 of this title, to provide an incentive to a health care provider who is employed by the multispecialty group of physicians under contract with the group model health maintenance organization; and

            (ii)    Shall allow a State–regulated payor to:

                1.    Request information from a health care provider to validate the health care provider’s incentive claim; and

                2.    If the State–regulated payor determines that a duplicate incentive payment or an overpayment has been made, reduce the incentive amount.

        (6)    The Commission may:

            (i)    Audit the State–regulated payor or the health care provider for compliance with the regulations adopted under this subsection; and

            (ii)    If it finds noncompliance, request corrective action.

        (7)    It is the intent of the General Assembly that the State Employee and Retiree Health and Welfare Benefits Program support the incentives provided under this subsection through contracts between the Program and the third party administrators arranging for the delivery of health care services to members covered under the Program.

    (c)    The Health Services Cost Review Commission, in consultation with hospitals, payors, and the federal Centers for Medicare and Medicaid Services, shall take the actions necessary to:

        (1)    Assure that hospitals in the State receive the payments provided under § 4102 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations; and

        (2)    Implement any changes in hospital rates required by the federal Centers for Medicare and Medicaid Services to ensure compliance with § 4102 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations.

    (d)    The Department, in consultation with the Commission, shall develop a mechanism to assure that health care providers that participate in the Maryland Medical Assistance Program receive the payments provided for adoption and use of electronic health records technology under § 4201 of the federal American Recovery and Reinvestment Act of 2009 and any subsequent federal rules and regulations.

    (e)    (1)    On or before October 1, 2012, the Commission shall designate one or more management service organizations to offer services throughout the State.

        (2)    The Commission may use federal grants and loans to help subsidize the use of the designated management service organizations by health care providers.

    (f)    On and after the later of January 1, 2015, or the date established for the imposition of penalties under § 4102 of the federal American Recovery and Reinvestment Act of 2009:

        (1)    Each health care provider using an electronic health record that seeks payment from a State–regulated payor shall use electronic health records that are:

            (i)    Certified by a national certification organization designated by the Commission; and

            (ii)    Capable of connecting to and exchanging data with the State–designated health information exchange; and

        (2)    The incentives required under subsection (b) of this section may include reductions in payments to a health care provider that does not use electronic health records that meet the requirements of paragraph (1) of this subsection.



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