Code of Maryland Regulations
Title 10 - MARYLAND DEPARTMENT OF HEALTH
Part 2
Subtitle 09 - MEDICAL CARE PROGRAMS
Chapter 10.09.10 - Nursing Facility Services
Section 10.09.10.19 - Pay-for-Performance - Payment Distribution

A. Beginning State fiscal year 2021, and each year thereafter, 1 percent of the budget allocation for nursing facility services shall be distributed based on pay-for-performance scores.

B. Eighty-five percent of the amount identified in §A of this regulation shall be distributed to the highest scoring facilities, representing 40 percent of the eligible days of care, in accordance with the methodology described in Regulation .16 of this chapter.

C. Funds shall be distributed among the facilities identified in §B of this regulation, based on the facility's relative score, such that the highest-scoring facility shall receive twice the amount per day as the lowest-scoring facility receiving payment.

D. Fifteen percent of the amount identified in §A of this regulation shall be distributed to the facilities that qualify for payment for improvement in accordance with Regulation .17 of this chapter.

E. Funds shall be distributed among the facilities included in §D of this regulation, based on a facility's relative point increase from the prior fiscal year, such that the facility with the greatest point increase shall receive twice the amount per day as the facility with the smallest point increase.

F. A facility shall receive a lump-sum payment based on the per diem amount determined in accordance with §C or E of this regulation, multiplied by the facility's Medicaid days of care in the facility's most recent cost report, not to exceed 1 year.