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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*sb0515*
SENATE BILL 515
J3 EMERGENCY BILL 6lr2697
CF HB 616
By: Senator Beidle
Introduced and read first time: February 3, 2026
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 6, 2026
CHAPTER ______
AN ACT concerning 1
Health Services Cost Review Commission – Health Facilities – Jurisdiction and 2
Rate Setting 3
FOR the purpose of altering the jurisdiction of the Health Services Cost Review 4
Commission; requiring authorizing the Commission, in carrying out certain 5
responsibilities relating to evaluating facility resources to meet certain financial 6
requirements and reviewing costs and rates of hospital services, to take into account 7
all reasonable costs incurred or expenditures made by a health facility in connection 8
with the operation of the facility; and generally relating to health facility rate setting. 9
BY repealing and reenacting, without amendments, 10
Article – Health – General 11
Section 19–211(a) and 19–219(a) 12
Annotated Code of Maryland 13
(2023 Replacement Volume and 2025 Supplement) 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 19–211(a), 19–212, and 19–219(b) 17
Annotated Code of Maryland 18
(2023 Replacement Volume and 2025 Supplement) 19
BY repealing and reenacting, without amendments, 20
Article – Health – General 21
Section 19–219(a) 22
2 SENATE BILL 515
Annotated Code of Maryland 1
(2023 Replacement Volume and 2025 Supplement) 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
That the Laws of Maryland read as follows: 4
Article – Health – General 5
19–211. 6
(a) (1) Except for a facility that is operated or is listed and certified by the First 7
Church of Christ Scientist, Boston, Massachusetts, the Commission has jurisdiction over 8
[hospital]: 9
(I) HOSPITAL services offered by or through all facilities; AND 10
(II) COSTS FOR A FACILITY ASSOCIATED WITH EMPL OYING OR 11
CONTRACTING WITH PHYSICIANS OR OTHER PROFESSIONAL PROVIDERS FOR WHICH 12
THE FACILITY DOES NO T RECEIVE CORRESPOND ING OFFSETTING PROFE SSIONAL 13
REVENUE. 14
(2) The jurisdiction of the Commission over any identified physician service 15
shall terminate for a facility on the request of the facility. 16
(3) The rate approved for an identified physician service may not exceed 17
the rate on June 30, 1985, adjusted by an appropriate index of inflation. 18
19–212. 19
The Commission shall: 20
(1) Require each facility to disclose publicly: 21
(i) Its financial position; and 22
(ii) As computed by methods that the Commission determines, the 23
verified total costs incurred and revenue generated by the facility in providing health 24
services; 25
(2) Review for reasonableness and certify the rates and revenue of each 26
facility; 27
(3) Keep informed as to whether a facility has enough resources to meet its 28
financial requirements BY TAKING INTO ACCOUNT ALL REASONABLE COSTS INCURRED 29
OR EXPENDITURES MADE BY THE FACILITY IN C ONNECTION WITH THE OPERATION 30
OF THE FACILITY, INCLUDING COSTS TO E MPLOY OR CONTRACT WI TH PHYSICIANS 31
SENATE BILL 515 3
OR OTHER PROFESSIONA L PROVIDERS FOR WHIC H THE FA CILITY DOES NOT 1
RECEIVE CORRESPONDING OFFSETTING PROFESSIONAL REVENUE; 2
(4) Concern itself with solutions if a facility does not have enough 3
resources; 4
(5) Assure each purchaser of health care facility services that: 5
(i) The total costs of all hospital services offered by or through a 6
facility are reasonable; 7
(ii) The aggregate rates of the facility are related reasonably to the 8
aggregate costs of the facility; and 9
(iii) Rates are set equitably among all purchasers of services without 10
undue discrimination; 11
(6) Develop guidelines for the establishment of global budgets for each 12
facility under Maryland’s all –payer model contract, including guidelines to prevent 13
facilities from taking actions to meet a budget that the Commission determines would have 14
adverse consequences for recipients or purchasers of services; 15
(7) Receive confirmation from Commission staff that facility global budget 16
agreements, as they are developed, are consistent with the guidelines; and 17
(8) After review by the Commission for compliance with the guidelines, 18
post each executed global budget agreement on the Commission’s website. 19
19–219. 20
(a) The Commission may review the costs, and rates, quality, and efficiency of 21
facility services, and make any investigation that the Commission considers necessary to 22
assure each purchaser of health care facility services that: 23
(1) The total costs of all hospital services offered by or through a facility 24
are reasonable; 25
(2) The aggregate rates of the facility are related reasonably to the 26
aggregate costs of the facility; and 27
(3) Except as provided in § 19 –214.2(l) of this subtitle, the rates are set 28
equitably among all purchasers or classes of purchasers without undue discrimination or 29
preference. 30
(b) (1) To carry out its powers under subsection (a) of this section, the 31
Commission [may]: 32
4 SENATE BILL 515
(I) MAY review REVIEW and approve or disapprove the 1
reasonableness of any rate or amount of revenue that a facility sets or requests; AND 2
(II) SHALL TAKE TAKE INTO ACCOUNT ALL REASONABLE COSTS 3
INCURRED OR EXPENDIT URES MADE BY THE FAC ILITY IN CONNECTION WITH THE 4
OPERATION OF THE FAC ILITY, INCLUDING COSTS TO E MPLOY OR CONTRACT WI TH 5
PHYSICIANS OR OTHER PROFESSIONAL PROVIDERS FOR WHICH THE FACILITY DOES 6
NOT RECEIVE CORRESPONDING OFFSETTING PROFESSIONAL REVENUE. 7
(2) A facility shall: 8
(i) Charge for services only at a rate set in accordance with this 9
subtitle; and 10
(ii) Comply with the applicable terms and conditions of the all–payer 11
model contract. 12
(3) Consistent with the all–payer model contract, in determining the 13
reasonableness of rates, the Commission may take into account objective standards of 14
efficiency and effectiveness. 15
SECTION 2. AND BE IT FURTHER ENACTED, That: 16
(a) On or before June 1, 2027, the Health Services Cost Review Commission, in 17
coordination with the Maryland Department of Health, the Maryland Insurance 18
Administration, and the Maryland Health Care Commission, shall report to the Senate 19
Finance Committee and the House Health Committee, in accorda nce with § 2–1257 of the 20
State Government Article, on the status of efforts to: 21
(1) collect and analyze data on costs incurred by hospitals to employ or 22
contract with physicians and other professional providers for which hospitals do not receive 23
corresponding offsetting professional revenue; and 24
(2) develop and implement a policy to address the costs identified under 25
item (1) of this subsection. 26
(b) If the Commission attempts to develop a policy under paragraph (a)(2) of this 27
section, the policy developed by the Commission shall seek to: 28
(1) ensure reasonable funding for physicians and other professional 29
provider services essential to the delivery of clinical care and the operations of a hospital; 30
(2) maintain access to providers in hosp itals and nonhospital based 31
settings; and 32
SENATE BILL 515 5
(3) ensure the State’s ability to meet its commitments under the Achieving 1
Health Efficiency through Accountable Design (AHEAD) model. 2
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
June 1, 2026. is an emergency measure, is necessary for the immediate preservation of the 4
public health or safety, has been passed by a yea and nay vote supported by three–fifths of 5
all the members elected to each of the two Houses of the General Assembly, and shall take 6
effect from the date it is enacted. 7
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.