Md. Code Regs. 10.37.10.17
The following forms are illustrative of pleadings and papers commonly used by parties in rate review proceedings and should be used wherever possible and, if necessary, adapted to the facts in the proceeding and the needs of the party using the forms:
| IN RE THE APPLICATION OF ____________ [ ] (Hospitals) | BEFORE THE MARYLAND HEALTH SERVICES COST REVIEW COMMISSION DOCKET: __________________________________________________ PAGE: ____________________________________________________ PROCEEDING NO.: __________________________________________ |
HEALTH SERVICES COST REVIEW COMMISSION PUBLIC NOTICE RATE PROCEEDING OF (specify type of application) __________ (name of hospital) (reference to proceeding)
PUBLIC NOTICE is hereby given that (specify type of application) has been filed (by-concerning) (name of hospital) before the Health Services Cost Review Commission in regard to the following rates or rate components:
(Specify services and old and new rates or rate components.)
Further notice shall be given when or if a public or general hearing is held.
The file of this application is available for public inspection at the offices of the Commission, 4160 Patterson Avenue, Baltimore, Maryland 21215, during regular business hours.
HEALTH SERVICES COST REVIEW COMMISSION
PUBLIC NOTICE OF PUBLIC HEARING HEALTH SERVICES COST REVIEW COMMISSION RATE PROCEEDING OF (specify type of application) __________ (name of hospital) (reference to proceeding)
Pursuant to regulations of the Commission, the public notice is hereby published of a public hearing before (the Commission) at (location), at (time) A.M. or P.M., on (date), to consider the following issue and/or rates of (name of hospital):
(Set forth issues and/or rates.)
The designated interested parties participating in this proceeding are:
Provider Reimbursement Department of Blue Cross of Maryland, Inc.
Medical Care Programs Administration of the Maryland Department of Health and Mental Hygiene (Medicaid).
Division of Provider Reimbursement and Accounting Policy, Bureau of Health Insurance, Social Security Administration, Department of Health, Education and Welfare of the United States (Medicare).
(List other designated interested parties, if any, for the hospital in question.)
Any person interested in this proceeding may attend the hearing.
All persons wishing to present relevant testimony or a statement at this public hearing shall forward copies to the hospital, each designated interested party and nine copies to the Commission office. The hospital and members of the public shall forward their testimony at least 8 days before the hearing. The designated interested parties shall forward their testimony at any time before the close of the first session. The Office of the Commission is as follows:
Health Services Cost Review Commission 4160 Patterson Avenue Baltimore, Maryland 21215
Address of designated interested parties may be obtained at the Commission's office at 764-2605.
All testimony and statements shall identify the proceeding to which they pertain, setting forth the name of the hospital and the docket, file and proceeding number, and must be signed by the person submitting the testimony or statement or by a representative of a group submitting testimony or a statement.
HEALTH SERVICES COST REVIEW COMMISSION PUBLIC NOTICE OF GENERAL HEARING CONCERNING RATE PROCEEDING OF (specify type of application) ______________ (name of hospital) (reference to proceeding)
Pursuant to rules of procedure of the Commission, public notice is hereby given of a general hearing in the above proceeding at (location), at (time) A.M., or P.M., on (date) concerning the following rates or rate components of (hospital):
(Specify services and old and new rates or rate components.)
Any person, group or organization interested in this matter may attend this hearing and present written or oral statements concerning the above rates or rate components.
Presentations may be limited as to time and the number of spokespersons representing any group or organization may be limited.
The file in the above proceeding is available at the offices of the Commission, 4160 Patterson Avenue, Baltimore, Maryland 21215.
HEALTH SERVICES COST REVIEW COMMISSION
PUBLIC NOTICE AS TO ORDERS NISI HEALTH SERVICES COST REVIEW COMMISSION
Pursuant to regulations of the Commission, public notice is hereby given of the following Order Nisi of the Commission: (Order Nisi is to be set forth in full, including tentatively approved rates and issues.)
Motions raising objections to the above tentatively approved rates and/or issues shall be submitted (in person or by mail) to the hospital and nine copies to the Commission office in legibly written or typed copies, within the above deadline, _________________, 20__, identifying the proceeding and Order Nisi to which objections are made.
A copy of the Commission's decision and opinions, if any, may be obtained by written request to the Commission office as follows:
Health Services Cost Review Commission 4160 Patterson Avenue Baltimore, Maryland 21215
Addresses of designated interested parties may be obtained at the Commission's offices at 764-2605.
The record of the complete proceeding in which the above Order Nisi was passed is open for public inspection at the above Commission offices during regular business hours.
HEALTH SERVICES COST REVIEW COMMISSION
ORDER NISI
Upon (open public hearing) (recommendation of Commission staff, etc.), it is this _____ day of _____________________, 20__, by the Maryland Health Services Cost Review Commission,
ORDERED, that (the following rate of ________________ hospital be and they hereby are approved), (whatever actions are to occur or whatever issues are to be resolved, etc.), as of the ____ day of ____________ 20__, unless reasonable cause to the contrary is shown on or before the ____ day of __________, 20__.
MARYLAND HEALTH SERVICES COST REVIEW COMMISSION
A majority of the Commission members have concurred in the above Order.
ORDER
Upon (consideration of Motion to _____________________)(recommendation of Commission's staff, (consideration of etc.), it is, this ____ day of ___________, 20__, by the Maryland Health Services Cost Review Commission,
ORDERED, that (requested action) be and it hereby is (approved, disapproved, etc.).
MARYLAND HEALTH SERVICES COST REVIEW COMMISSION
A majority of the Commission members have concurred in the above Order.
MOTION
(Name of movant) hereby moves that the Health Services Cost Review Commission (described action to be taken or question to be answered) and as reasons therefore states:
(Set for the reasons, authorities, citations, etc.)
(date)(signature of movant)
(Type name, title, if any, and address and telephone number of movant)
CERTIFICATE OF SERVICE
I HEREBY CERTIFY THAT on this ____ day of ___________,20__, I (mailed or caused to be mailed) (served or caused to be served) a copy of the above describe pleading) upon (state name and address of a party (parties) or attorney (attorneys) upon whom a copy of the pleading was served)
Date: __________________, 20__
_____________________________________________________________________________ (Signature of party filing pleading)
WRIT OF SUBPOENA DUCES TECUM
TO: (name and address of person subpoenaed)
You are hereby summoned to appear in person at the Commission's offices, 4160 Patterson Avenue, Baltimore, Maryland 21215 on (date) at (time) to give testimony under oath concerning the above proceeding.
You are also commanded then and there to produce the following documents and records:
(description of documents and records)
____ (date) _________________________________________________________________ Health Services Cost Review Commission
WRIT OF SUMMONS
TO: (Name and address of person summoned)
You are hereby summoned to appear in person at the Commission's offices, 4160 Patterson Avenue, Baltimore, Maryland 21215 on (date) at (time) to give testimony under oath concerning the above proceeding.
____ (date) _________________________________________________________________ Health Services Cost Review Commission
WRIT OF SUMMONS
TO: (Name and address of person summoned)
You are hereby summoned to appear in person at a public hearing before (the Commission), at (location) on (date) at (time) to testify under oath thereat.
____ (date) _________________________________________________________________ Health Services Cost Review Commission
WRIT OF SUBPOENA DUCES TECUM
TO: (name and address of person subpoenaed)
You are hereby summoned to appear in person at a public hearing before (the Commission), in the above proceeding at (location) on (date) at (time) to testify under oath thereat.
You are also commanded then and there to produce the following documents and records:
(description of documents and records)
____ (date) _________________________________________________________________ Health Services Cost Review Commission
Md. Code Regs. 10.37.10.17