Maryland Code § HG-19-143

Section HG-19-143
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(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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