When choosing and utilizing the services of a hospital, it is important to understand the rules and standards under which the hospital operates. This section includes information on specific sections of the Code of Maryland Regulations (COMAR) for hospitals and information about the various agencies responsible for oversight and accreditation of Maryland's hospitals.
CODE OF MARYLAND REGULATIONS
Hospitals in Maryland are licensed and regulated by the Department of Health and Mental Hygiene and must adhere to the regulations set forth in the Code of Maryland Regulations (COMAR) for hospitals.
The regulations of greatest interest to hospital patients and their families are identified below:
COMAR
10.07.01.08 Complaint Investigations
This section authorizes the Department
of Health and Mental Hygiene to investigate and resolve any complaints
concerning patient care, safety,
medical and nursing supervision, dietary matters, physical environment
and sanitation, and it directs the manner in which complaints are handled.
COMAR
10.07.01.13 Utilization Review Plan
This section identifies the requirements for a utilization review plan.
Utilization review looks at the medical necessity of care given or proposed
to be given, the quality of care and the appropriateness of care given
at the hospital.
COMAR
10.07.01.15 Performance Standards for Utilization Review
This section identifies when a utilization review should take place.
COMAR
10.07.01.16 Protection of Patients—Patient Liability
This regulation
states that if a utilization review finds that the patient should not have
been charged for a procedure, he or she must receive a revised bill that
explains all deductions.
COMAR
10.07.01.21 Procedures for Which Preauthorization is Required
This regulation
details all medical procedures for which preauthorization from one's insurance
company is required.
COMAR
10.07.01.23 Guidelines Governing the Transfer of Patients Between Hospitals
This section identifies the circumstances under which a patient can and
cannot be transferred to another hospital.
COMAR
10.07.01.24 Physician Credentialing Process
This regulation describes the process a hospital must follow to credential
physicians who will admit or treat patients at that facility.
COMAR
10.07.01.26 Anatomical Donations
This section
details the procedures hospital staff must follow when requesting donations
on the death of a patient.
COMAR 10.07.06
This section requires hospitals to carry out a number of activities, the purpose of which is
to provide a safe environment for patients.