Md. Code Regs. 10.37.12.01

Current through Register Vol. 51, No. 25, December 13, 2024

Section 10.37.12.01 - Definitions

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) "Cross-subsidization" means the practice of charging a purchaser or class of purchaser more than the cost of care for a service with the result that another purchaser or class of purchaser is charged less than the cost of care for the same service.

(2) "Discount" means a reduction to Commission-approved rates.

(3) "Fixed-price contract" means an agreement or contract, written or oral, that sets forth a preestablished price for the provision of hospital services, or for the provision of hospital services in combination with physician or other services, that differs from Commission-approved rates.

(4) Related Entity.

(a) "Related entity" means an entity that is entering into at-risk arrangements for hospital-provided services and which is either subject to the exercise of control or significant influence by the management or operating policies of a hospital or exercises control over the management or operating policies of a hospital. In either event, one of the entities is, or may be, prevented from fully pursuing its own separate interests by virtue of its relationship with the other entity.

(b) Examples of "related entity" transactions include transactions between:

(i) A parent and its subsidiaries;

(ii) Subsidiaries of a common parent;

(iii) An entity and trusts for the benefit of employees that are managed by or under the trusteeship of the entities' management;

(iv) An entity and its principal owners, management, or members of their immediate families;

(v) Affiliates (an entity that, directly or indirectly through one or more intermediaries, controls, is controlled by, or is under common control of another entity);

(vi) An entity and a joint venture whose participants include the entity or a related entity; and

(vii) Two entities, both of which are related, directly or indirectly, to a common entity.

Md. Code Regs. 10.37.12.01

Regulations .01 adopted effective February 17, 1992 (19:3 Md. R. 305)
Regulation .01 amended effective June 7, 1993 (20:11 Md. R. 913); December 2, 1996 (23:24 Md. R. 1683)