COMAR Regulations Title 10, Subtitle 25
COMAR Chapters 10.25.01—10.25.19 include regulations that authorize the Commission to:
- Impose user fee assessments on health care practitioners and facilities
- Collect and evaluate quality and performance data from hospitals and health benefit plans
- Collect data from Maryland health care practitioners
- Collect data for and operate the Maryland Medical Care Data Base
- Certify Electronic Health Networks and Medial Care Electronic Claims Clearinghouses
- Establish requirements for payers to designate Electronic Health Networks
- Regulate the Maryland Trauma Physician Services Fund
- Establish an Institutional Review Board regarding release of sensitive data from the Medical Care Data Base
- Impose fines on health care facilities and practitioners
- Set forth health information technology funding applications
- Designate State Management Service Organizations
- Establish electronic health record Incentives
- Set forth benchmarks for preauthorization of health care services
- Establish protections for the privacy and security of protected health information in Health Information Exchanges
- Establish State recognition of an electronic Advance Directive Service
This chapter addresses the requirements, parameters, administrative process, and procedures for submission, review, approval, and disapproval of requests for data from the Maryland Medical Care Data Base, any other information collected and stored in the Maryland Medical Care Data Base, and any data submitted to the Maryland Health Care Commission from a claims clearinghouse.
COMAR 10.25.06 Maryland Medical Care Data Base and Data Collection
These regulations establish appropriate methods for collecting and compiling Statewide data on selected health care services provided either under a Maryland contract or to Maryland residents by health care practitioners and facilities:
COMAR 10.25.14 Health Care Data Collection from Maryland Health Care Practitioners
The Health Care Data Collection from Maryland Health Care Practitioners regulations applies to the collection of health care data, by the Maryland Health Care Commission, from health care practitioners in the State.
COMAR 10.25.01 Small Employer Health Benefits Plan Premium Subsidy Program
Small Employer Health Benefits Plan Premium Subsidy Program is designed to provide an incentive for small employers to offer and maintain a small employer health benefit plan for their employees.
COMAR 10.25.08 - Evaluation of Quality and Performance of Health Benefit Plans
The evaluation system described in this chapter is designed to address the information needs of consumers and purchasers by providing an assessment of the quality and performance of health benefit plans based on measures endorsed or implemented by nationally recognized organizations involved in quality of care and performance measurement.
This chapter provides for the certification of electronic health networks and medical care electronic claims clearinghouses that operate in Maryland. The chapter also includes provisions to ensure protections for legally protected health information and requirements for reporting certain electronic health care transactions to the State-Designated Health Information Exchange.
COMAR 10.25.09 Requirements for Payers to Designate Electronic Health Networks
The regulations set forth a process by which certain payers must contract with MHCC-certified electronic health networks for the exchange of electronic health care transactions originating in Maryland. The regulations also include a process for payors to annually report activity on electronic health care transactions to MHCC.
COMAR 10.25.13 Health Information Technology Funding Applications
The regulations apply to MHCC's consideration of an application for funding that is responsive to an announcement posted by MHCC regarding one or more specified areas of health information technology.
COMAR 10.25.15 Management Service Organization State Designation
The regulations set forth procedures for State Designation of entities that provide technology and consultative services to health care providers.
COMAR 10.25.16 - Electronic Health Record Incentives
The regulations provide a framework for State-regulated payors required to provide incentive payments to providers that use electronic health records.
COMAR 10.25.17 - Benchmarks for Preauthorization of Health Care Services
This chapter applies to payors required to attain certain preauthorization benchmarks and the process and circumstances by which payors may be waived from compliance with a benchmark.
COMAR 10.25.18 - Health Information Exchanges: Privacy and Security of Protected Health Information
This chapter governs the privacy and security of protected health information accessed, used, or disclosed by a health information exchange, improves access to clinical records by treating providers, and supports public health goals. The chapter also includes provisions to ensure protections for legally protected health information, requirements to support reporting of non-controlled prescription drug dispenses, and a framework for the development and implementation of a centralized consent management application and the operation and maintenance of a health data utility by the State-Designated Health Information Exchange.
COMAR 10.25.19 - State Recognition of an Electronic Advance Directive Service
This chapter sets forth procedures for State Recognition of entities offering electronic advance directives services that want to be authorized to connect to the State-Designated Health Information Exchange.
COMAR 10.25.04 Hospital Quality and Performance Evaluation System
The Hospital Quality Performance Evaluation System regulations establish a process for reporting by hospitals information to be used by the Commission in the development of an annual comparative evaluation of hospitals.
COMAR 10.25.12 Imposition of Fines
The Imposition of Fines regulations, establishes a process for the assessment of fines for failure to file timely and accurate reports or other information.
COMAR 10.25.11 Institutional Review Board
The Institutional Review Board regulations establish an Institutional Review Board to assist the Commission in making decisions regarding release of sensitive data from the Maryland Health Care Commission Medical Care Data Base. The regulations set forth processes and standards governing release of the data.
COMAR 10.25.10 - Maryland Trauma Physician Services Fund
The Maryland Trauma Physician Services regulations apply to trauma physicians and Maryland Institute of Emergency Medical Services Systems-designated trauma centers that provide trauma care. Trauma physicians seeking reimbursement for uncompensated care provided to trauma patients shall file an application pursuant to this chapter to receive reimbursement from the Maryland Trauma Physician Services Fund. Trauma physicians seeking reimbursement for trauma care provided to trauma patients enrolled in the Maryland Medical Assistance Program at the elevated rate shall comply with special billing requirements pursuant to this chapter. Trauma centers seeking reimbursement for cost maintaining trauma physicians on-call shall file an application to receive reimbursement from this fund.
COMAR 10.25.02 User Fee Assessment on Health Care Practitioners
The User Fee Assessment on Health Care Practitioners regulations set forth the general method for assessing user fees on Health Care Practitioners to fund the activities of the Commission.
COMAR 10.25.03 User Fee Assessment of Payers, Hospitals and Nursing Homes
The User Fee Assessment of Payers, Hospitals and Nursing Homes regulations set forth the general method for assessing user fees on payers, hospitals and nursing homes to fund the activities of the Commission.
Title 31 MARYLAND INSURANCE ADMINISTRATION Subtitle 11 HEALTH INSURANCE
The Maryland Insurance Administration (MIA) and the Maryland Health Care Commission (MHCC) work collaboratively to support the effective implementation and oversight of COMAR Title 31, including Subtitles 11.06, 11.12, and 11.14.
Under these regulations, MIA is responsible for regulating health insurers and ensuring compliance with requirements related to network adequacy, consumer protections, and coverage standards. MHCC supports this work by providing data, analysis, and health system planning expertise.
COMAR 31.11.06 - Comprehensive Standard Health Benefit Plan
The Comprehensive Standard Health Benefit Plan regulation allows the Maryland Insurance Administration and the Maryland Health Care Commission to identify the uniform benefits which must be offered in the comprehensive standard health benefit plan by carriers marketing in the small employer market, the delivery systems to market the plan, and the cost-sharing arrangements applicable to each delivery system.
COMAR 31.11.12 - Limited Benefit Plan
The Limited Benefit Plan applies to all carriers that offer the Limited Benefit Plan to small employer market. This chapter identifies the uniform benefits which shall be offered in a Limited Benefit Plan which a carrier offers to a Maryland small employer.
COMAR 31.11.14 - Wellness Benefits Under Small Employer Health Benefit Plans
Wellness Benefits under Small Employer Health Benefit Plans specifies the requirement for a wellness benefit offered by a carrier to a small employer under Insurance Article, Title 15, Subtitle 12, Annotated Code of Maryland. Determining when a carrier is considered a prominent carrier; and carriers offering wellness benefits to small employers.