Section 11-205 - Payment rates to health care provider. - Maryland Statutes

§ 11-205. Payment rates to health care provider.
 

(a)  Definitions.-  

(1) In this section the following words have the meanings indicated. 

(2) (i) "Health care provider" has the meaning stated in § 19-132 of the Health - General Article. 

(ii) "Health care provider" does not include a hospital regulated by the Health Services Cost Review Commission. 

(3) "Health care service" has the meaning stated in § 19-132 of the Health - General Article. 

(4) "Medicaid rate" means: 

(i) the amount a health care provider would be paid for health care services under a contract or provider agreement with the Maryland Medical Assistance Program; or 

(ii) if the health care provider is a federally qualified health center, the amount that a federally qualified health center would be paid by the Maryland Medical Assistance Program using the payment methodology described in 42 U.S.C. § 1396a(bb). 

(b)  Amount.- Liability for payment to a health care provider for any health care service provided to an inmate committed to a local correctional facility that is not provided on the premises of the facility may not exceed the lesser of: 

(1) the actual amount billed by the health care provider for the health care service; or 

(2) the Medicaid rate for the health care service. 

(c)  Election and withdrawal.-  

(1) A county may elect to declare the provisions of this section inapplicable to the county by filing with the county health officer a written declaration by the highest official of the local correctional facility, approved by the chief executive officer of the county. 

(2) The highest official of the local correctional facility, with the approval of the chief executive officer of the county, may withdraw at any time an election made under paragraph (1) of this subsection. 
 

[2008, ch. 496.]