Code of Maryland Regulations (Last Updated: April 6, 2021) |
Title 10. Maryland Department of Health |
Part 2. |
Subtitle 09. MEDICAL CARE PROGRAMS |
Chapter 10.09.47. Disproportionate Share Hospitals |
Sec. 10.09.47.02. Disproportionate Share Hospitals
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A. A Maryland hospital is considered a disproportionate share hospital for purposes of a disproportionate share payment if the hospital's:
(1) Medicaid inpatient utilization rate is at least one standard deviation above the mean Medicaid inpatient utilization rate for Maryland hospitals that are Medicaid providers; or
(2) Low-income utilization rate exceeds 25 percent.
B. To be considered a disproportionate share hospital, a hospital shall have at least two obstetricians with staff privileges who have agreed to provide obstetrical services to individuals who are entitled to Medical Assistance for services under Title XIX of the Social Security Act.
C. The requirements set forth in §B of this regulation do not apply to a hospital if:
(1) Inpatients are predominately individuals younger than 18 years old; or
(2) The hospital did not provide nonemergency obstetric services as of December 22, 1987.
D. Data for §A(1) and (2) of this regulation relate to the State fiscal year occurring 2 years before the fiscal year during which payments are made.