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MD Health Code § 19-133 - Maryland medical care data base

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The Maryland Health Care Commission must establish a Maryland Medical Care database to compile statewide health data submitted by health care practitioners and facilities.  The Medical Care Database must collect the following information for each patient encounter with a provider or facility:

  • Patient’s demographic characteristics
  • Principal diagnosis
  • Procedure performed
  • Date and location of the procedure
  • Charge for the procedure
  • If bill was submitted assigned or unassigned
  • Practitioner’s universal identification number
  • Identification if the provider is a registered nurse, nurse anesthetist, or midwife.
  • Information related to prescription drugs

The Database must also collect information related to health care costs, utilization or resources from payors or governmental agencies. 

The Commission must adopt regulations allowing access and retrieval of medical claims data and other information stored in a medical care claims database or other state licensed clearinghouse.  The Commission must ensure that patient information is kept confidential. 

When collecting data, the Commission must ensure that standardized claim forms or electronic systems being used by providers, facilities and payers is used. 

The Commission must publish an annual report  on certain health care services selected by the Commission that describes the variation in fees charged by practitioners and facilities on a statewide basis for certain services ands describes the geographic variation of utilization of those services.  The Commission must also annually publish:

  • Total reimbursement for all health care services annually
  • Total reimbursement for each heath care specialty annually
  • Total reimbursement for each code annually
  • Annual rate of change for each health care service by specialty and code.

The Commissioner may also publish other appropriate information on capitated health care services. 

The Commission must work with the Health Services Cost Review Commission and other stakeholders to ensure that the medical care database is compatible with information collected by the Health Services Cost Review Commission .

Current as of June 2015