This statute governs payment responsibilities of the Maryland Department of Health when an emergency psychiatric evaluee cannot pay or lacks insurance coverage. The Department must pay the actual cost or a reasonable rate (whichever is lower) for emergency services, initial consultant examinations, and transportation related to emergency evaluations and involuntary admissions. The Department is also subrogated to any available insurance coverage for these charges. Facility operators should be aware of the applicable rate-setting methodology and the Health Services Cost Review Commission's role in setting hospital payment rates.
View official source- 1 - Article - Health - General [Previous][Next] §10–628. (a) (1) If an emergency evaluee cannot pay or does not have insurance that covers the charges for emergency services, an initial consultant examination by a physician, physician assistant, or nurse practitioner, and transportation to an emergency facility and, for an involuntary admission of the emergency evaluee, to the admitting facility, the Department shall pay the appropriate party the actual cost or a reasonable rate for this service, whichever is lower, except that hospitals shall be paid at rates approved by the Health Services Cost Review Commission. (2) The reasonable rate for the services provided under an emergency petition shall be calculated by using a methodology established by regulation and reasonably related to the actual cost. (b) With respect to emergency admissions, the Department shall be subrogated against any insurance coverage available to the patient for charges relating to emergency service, initial consultant examination by a physician or nurse practitioner, and transportation to an emergency facility under Part IV of this subtitle. [Previous][Next]