Sec. 10.09.47.01. Definitions

A. In addition to the definitions contained in §B of this regulation, definitions set forth in COMAR 10.09.06.01 are applicable to this chapter.

B. Terms Defined.

(1) "Charity care" means hospital care for which the costs are not reimbursed through any patient or third party.

(2) "Charity care inpatient costs" means hospital costs that are not reimbursed through any patient or third party, reduced by the amount of gifts, restricted grants, or income from endowments. For the purposes of this chapter, third party payments include Medicaid payments for the cost of care, but do not include disproportionate share payments.

(3) "Low-income hospital costs" means the sum of a hospital's:

(a) Inpatient Medicaid costs;

(b) State and local government inpatient cash subsidies; and

(c) Charity care inpatient costs.

(4) "Low-income utilization rate" means, for a hospital, the sum of:

(a) A fraction, expressed as a percentage:

(i) The numerator of which is the sum, for a fiscal year, of the total revenues paid the hospital for patient services under a Medical Assistance Program, and the amount of cash subsidies for patient services received directly from State and local governments, and

(ii) The denominator of which is the total amount of revenues of the hospital for patient services, including the amount of the cash subsidies in the fiscal year; and

(b) A fraction, expressed as a percentage:

(i) The numerator of which is the total amount of the hospital's charges for inpatient hospital services that are attributable to charity care in a fiscal year, less the portion of any cash subsidies described in §B(4)(a)(i) of this regulation in the period reasonably attributable to inpatient hospital services, and

(ii) The denominator of which is the total amount of the hospital's charges for inpatient hospital services in the hospital in the period reasonably attributable to inpatient hospital services.

(5) "Medicaid cost" means an amount equal to Medicaid payments by the Medicaid program.

(6) "Medicaid inpatient utilization rate" means a fraction, expressed as a percentage:

(a) The numerator of which is the hospital's number of inpatient days attributable to patients who were eligible for Medical Assistance benefits under Title XIX of the Social Security Act for a fiscal year; and

(b) The denominator of which is the total number of the hospital's inpatient days for the fiscal year in §B(6)(a) of this regulation.

(7) "State and local government inpatient cash subsidies" means the payments for hospital costs from State or local government health agencies that are not intended as reimbursement for costs directly associated with particular patients, but are provided more generally for operating costs of the institution. These subsidies do not include Medicaid payments or disproportionate share payments.