Johns
Legislative Hotline
2005 SESSION OF THE
MARYLAND GENERAL ASSEMBLY
Volume 13, Number 3 February 2, 2005
Here are some of the hot issues as the 2005 Legislative
Session develops:
Additional Details for the FY 2006 Operating Budget
BILLS
INTRODUCED
STAFF CONTACT INFORMATION
On Wednesday Governor
Ehrlich introduced the $947.5 million FY 2006 capital budget and five-year
capital improvement plan. The capital
budget focuses almost 75% of available funding for education, health, and the
environment. Two projects requested by
Johns Hopkins Medicine are included in the budget for a total state commitment
of $50 million over five years to support both the Children’s &
|
Project (in millions) |
FY 2006 |
FY 2007 |
FY 2008 |
FY 2009 |
FY 2010 |
|
Johns |
|||||
|
Cardio.
& Critical Care |
$5.0 |
$5.0 |
$5.0 |
$5.0 |
$5.0 |
|
Pediatric
Trauma |
5.0 |
5.0 |
5.0 |
5.0 |
5.0 |
|
University of |
|||||
|
Treatment
Facilities ( |
10.0 |
2.5 |
5.0 |
2.5 |
|
|
|
5.0 |
2.5 |
5.0 |
10.0 |
10.0 |
|
|
|||||
|
UMB
– |
1.2 |
|
|
|
|
|
UMB
– Pharmacy Hall |
|
|
2.2 |
2.7 |
32.0 |
|
Other Projects |
|||||
|
|
5.0 |
5.0 |
5.0 |
5.0 |
5.0 |
|
Westside
Redevelopment |
5.0 |
5.0 |
5.0 |
5.0 |
5.0 |
|
Great
Blacks in Wax |
1.3 |
|
|
|
|
|
KKI
– Research Ctr. |
1.0 |
1.0 |
1.0 |
1.0 |
|
|
MD
Hospital Association |
|
5.0 |
5.0 |
5.0 |
5.0 |
|
|
2.0 |
1.0 |
|
|
|
|
Our Daly
Bread |
4.0 |
1.0 |
|
|
|
It should be noted that two
groups of projects were excluded from the capital budget as introduced. Traditionally, the Governor’s budget includes
approximately $15 million for legislative initiatives and $5 million for the
Maryland Hospital Association Bond program.
For more information, please
contact Jim Kaufman.
MICUA Capital Grants
As part of the FY 2006 capital budget plan, the
Governor provided $8 million for three capital projects at MICUA member
institutions:
The Governor also included in his five-year capital
plan $8 million annually for
For more information, please contact Bret Schreiber.
As reported last week, the Governor provided a 2%
increase for Sellinger in his FY 2006 allowance. Even with this increase Sellinger
is still not at the full statutory level.
There is a push by legislative leadership at this time to potentially to
restore Sellinger Program either partially or in its
entirety. If this comes to fruition and
the program is restored in its entirety it would be $46 million, a 32% increase
over fiscal 2005.
For more information, please contact Bret Schreiber.
Additional Details for the FY 2006 Operating Budget
While the FY 2006 operating
budget was released last week and details of each budget allocation will not be
available until the budget hearings, additional information is now available
about budget reductions. For the health
care community, the following reductions are imbedded in the budget:
Ÿ
Continuation of
the Medicaid day limits on hospitals, totaling $40 annually
Ÿ
1% reduction to
Medicaid Managed Care Organizations capitation rates
Ÿ
$42 million
reduction in total funds for nursing homes, comprising $18 million in
reductions that will be continued and $24 in additional cuts
Ÿ
Elimination of
the Rare and Expensive Case Management Program (REM) in Medicaid, shifting
these patients to HealthChoice with a corresponding
$6 million reduction
Ÿ
Elimination of
inflation adjustment for adult day care programs
Ÿ
Medical review
of vent patients in chronic hospitals
Ÿ
Elimination of
the legal aliens health care program that impacts 4,000 individuals, 700 of
whom are pregnant woman
For more information, please contact Jim Kaufman.
On Tuesday, January 25, the
Administrative, Executive, and Legislative Review Committee (AELR), held a hearing
on the proposed Medicaid regulations that include the CY 2005 Medicaid Managed
Care Organizations (
For more information, please contact Jim
Kaufman
To date 13 bills have been introduced regarding medical
malpractice reform. Some of the
initiatives include limited immunity for emergency room providers, full apology
protection, the division of lawyers’ fees, and qualifications for an
attesting expert or expert witness. The
Administration has also introduced a comprehensive bill which includes some
fairly significant tort reform measures, such as capping noneconomic
damages and wrongful death at $500,000 and permanently removing the escalator,
structured settlements, itemization of the award and mandating the use of a
neutral expert. We expect more bills to
be introduced including one to make the necessary technical corrections to HB 2
of the Special Session.
For more information, please contact Heather Barthel.
BILLS INTRODUCED
HB0155 Creation of a State Debt - Baltimore County -
Northwest Hospital Center
The bill authorizes $800,000 in state bonds to support
the renovations and capital equipping of the intensive care unit, located at
Northwest Hospital Center’s Baltimore County campus.
Effective Date:
June 1, 2005
For more information, please contact: Jim Kaufman
HB0201 Creation of a State Debt - Mercy Medical Center
The bill authorizes $800,000 in state bonds for the
renovation and modernization of the inpatient beds located at Mercy Medical
Center’s Baltimore City campus.
Effective Date:
June 1, 2005
For more information, please contact: Jim Kaufman
HB0148 Budget Reconciliation Act of 2005
House Bill 148, the
Budget Reconciliation and Financing Act, amends the allowance for the Sellinger
Aid program for Independent Higher Education institutions. The funding under HB 148 is $10 million less
than included in the FY 2006 budget allowance.
The bill also includes
language eliminating the Senior Prescription Drug Program effective January 1,
2006, and transferring the subsidy paid by CareFirst BlueCross and BlueShield
of Maryland to the Maryland Pharmacy Assistance Program. For CY 2006, the subsidy shall equal $11.7 million
and beginning in CY 2007 and each year thereafter total $23.0 million.
In addition, the bill
amends the Public Health Grant paid to each Johns Hopkins and University of
Maryland to $1.2 million for FY 2006 only.
Effective Date:
June 1, 2005
For more information, please contact: Bret Schreiber
HB0014 Department of Health and Mental Hygiene - Prenatal
Dietary Supplement Distribution Program
To reduce the number
of cases of neural tube and other birth defects in the State of Maryland, HB 14
requires DHMH to establish a program for distribution of: 1- prenatal
multivitamins and mineral dietary supplements with the recommended levels of
Folic Acid to women of childbearing age (women ages 15 to 45 who qualify for
WIC); and 2- counseling and written information regarding the proper use of the
supplements. HB 14 also provides for the
program to be funded by the state budget, the federal Women, Infants and
Children (WIC) food program as well as other lawful sources.
.Effective Date:
October 1, 2005
For more information, please contact: John Safapour
Health Care Facilities
HB0199 Hospital Infections Disclosure Act
The bill requires the
Maryland Health Care Commission (MHCC) to collect data on hospital-acquired
infection rates from hospitals. MHCC
will be required to adopt regulations that:
1) establish the time,
format and process of submission;
2) identify the types of
hospital-acquired infections on which hospitals must collect and report data;
and
3) establish procedures for
ensuring complete confidentiality of patients, employees and licensed health
professionals in the reports submitted.
Reports are to be made
available to the public by September 1, 2006.
In addition, MHCC will be required to publish an annual report,
beginning December 1, 2006, summarizing the hospital-acquired infection data
submitted at hospitals. The report must
include: 1) a comparison of risk-adjusted hospital-acquired infection rates for
each hospital in the state, and
2) a discussion of findings
and trends, including comparisons to prior years.
Hospitals that do not
comply with the data collection and/or reporting requirements may be subject to
delicensure or a fine of up to $1,000 per day per violation.
Effective Date:
July 1, 2005
For more information, please contact: Sheila Higdon
HB0254 Department of Human Resources - Disclosure of
Information - Hospitals and Birthing Centers
When the medical or
human resources personnel of a hospital or birthing center have reasonable and
articulable concerns about the safety of a child after discharge, SB220 and HB
254 authorize the disclosure of
records and reports
concerning child abuse or neglect for the purpose of making discharge decisions
for that child.
Effective Date:
July 1, 2005
For more information, please contact: John Safapour
SB0250 Public Health - Medical Laboratories - Inspection,
Information Sharing, and Whistleblower Protection
SB 210 amends current
statute regarding the inspection of medical laboratories, providing that DHMH
inspections will be unannounced. The bill also authorizes lab employees to
disclose information to the Secretary of Health that the employee believes
evidences:
1) abuse of authority,
gross mismanagement or gross waste of money;
2) substantial and specific
danger to public health and safety; and
3) violations of the standards
and requirements for medical laboratories in the state.
In addition, provisions of
the bill protect employees from being subject to adverse employment action as a
result of disclosure of information and/or for agreeing to cooperate with an
investigation of a medical lab. It
authorizes such employees to take civil action against the medical lab if
adverse employment action is taken against an employee who discloses the
above-referenced information.
The bill also requires the
Secretary of Health to develop and disseminate a document that informs medical
lab employees on the manner in which to report instances of noncompliance or
violation. The document shall include
the name and contact information of the State agency, the types of reportable
offenses, a description of the rights and protections to which they are
entitled, and a toll-free reporting number.
Medical labs will be required to post the document in a conspicuous
place.
The Secretary will be
required to provide notice to any organization that has oversight authority
over medical laboratories in the state of a discovery or report of
noncompliance or other violation. A
standard format and method of transmission of this information will be
developed by the Secretary.
The bill also stipulates
that the Secretary may impose a fine of up to $2000 on a person who notifies a
medical laboratory of the time or date on which an unannounced inspection is
scheduled to be conducted.
Effective Date:
July 1, 2005
For more information, please contact: Sheila Higdon
Health Care Practitioners
HB0233 Public Health - Legibility of Prescriptions Workgroup
- Reports
The bill extends the time for the workgroup to
complete its work on the study of prescription legibility and requires that an
interim report be submitted February 1, 2005.
A final report will be due by August 15, 2005.Effective Date:
October 1, 2005
For more information, please contact: Sheila Higdon
HB0177 Health Care Facilities - Oversight Committee on
Quality of Care in Nursing Homes - Additional Duties and Sunset Extension
The bill alters the duties of the Oversight Committee
on Quality of Care in Nursing Homes by adding a duty to consider the quality of
care of mentally ill patients in nursing homes.
It also extends the termination date of the Oversight Committee to
December 31, 2006.
Effective Date:
October 1, 2005
For more information, please contact: Sheila Higdon
HB0222 Assisted Living Programs - Criteria for Requiring
Manager Training
The bill amends
current law regarding training requirements for managers of assisted living
programs, requiring that managers of facilities with 5 or more beds complete
the training that is now required of managers of facilities with 17 or more
beds.
.Effective Date:
October 1, 2005
For more information, please contact: Sheila Higdon
HB0229 Senior Citizen Prescription Medicine Releif Act of
2005
The bill requires any pharmacy that participates in
the Medicaid Program to charge a Medicare beneficiary the same price and
dispensing fee as offered under the Medicaid program. In addition, the bill states that DHMH shall
transmit the program reimbursement rate to the pharmacy, but may not apply any
program drug utilization review process for this program. The bill sunsets on September 30, 2008, with
no further action by the General Assembly.
Effective Date:
October 1, 2005
For more information, please contact: Jim Kaufman
HB0231 Prescription Drugs - Canadian Mail Order Plan
The bill requires DHMH to seek a waiver before
November 1, 2005 from the Food and Drug Administration that would allow the
State to operate a Canadian drug importation program. In addition, the Department would seek
approval from the Centers for Medicare and Medicaid Services to allow state
funds used to operate the Canadian drug importation program to qualify for
federal matching funds. If the waiver
request is denied, the bill requires DHMH to file a lawsuit against the FDA.
Effective Date:
July 1, 2005
For more information, please contact: Jim Kaufman
HB0176 Prescription Drugs - Senior Citizens - Purchasing
Outside the State
The bill requires the
Department of Health & Mental Hygiene to evaluate a process for assisting
senior citizens in purchasing reduced-cost prescription drugs from sources
outside the State if the process is feasible, cost effective, and consistent
with federal law and regulation. A
report on the findings is due to
the Governor and General
Assembly by October 1, 2006.
Effective Date:
June 1, 2005
For more information, please contact: Sheila Higdon
Public Health
SB0129 Energy Assistance Program Act
The bill renames the Energy Assistance and Information
Program Act to the Energy Assistance Program Act. The bill redefines “Energy
Emergency” to include a lack of fuel or the imminent discontinuation of
services. It also changes the office
within the Department of Human Resources that administers the program to the
Office of Home Energy Programs in the Community Services Administration and
creates the Office of Home Energy. The
bill amends who is eligible to only low income households, the bill deletes
“the near poor, the elderly and those on fixed incomes.” The bill eliminates the cap of $250 per year
to any qualifying household.
Effective Date:
October 1, 2005
For more information, please contact: Heather Barthel
HB0203 Income Tax Credit for Services Donated by Health Care
Professionals
The bill allows a
local community health organization to request income tax credits from the
Department of Health and Mental Hygiene
(DHMH). The proposal submitted to DHMH
must include the program to be conducted, low-income population to be targeted,
and the estimated value of service to be provided. The Department may allocate up to $250,000
worth of credits annually, and a health care worker may claim a credit equal to
25% of the value of the services to be donated or the amount of credit assigned
by the community health organization.
The value of the services is calculated by the reasonable costs for similar
services or $50 per hour of time donated.
The bill requires the
Comptroller and DHMH to study the effectiveness of offering the credits and
report back to Senate Budget and Taxation Committee and House Ways and Means
Committee by November 1, 2007. The bill sunsets
on June 30, 2009.
The bill requires the
Comptroller and DHMH to study the effectiveness of offering the credits and
report back to Senate Budget and Taxation Committee and House Ways and Means
Committee by November 1, 2007. The bill
sunsets on June 30, 2009.
Effective Date:
June 1, 2005
For more information, please contact: Sheila Higdon
HB0157 Medical Professional Liability Insurance - Reporting
Requirements
This Departmental bill modifies §4-401 of the
Insurance Article to require an insurer, including self insured hospitals, to
include in its required quarterly report on personal injury claims information
regarding the jurisdiction where a suit is filed and the specific amount of the
final judgment or settlement that is for
past and future medical expenses, past and future lost wages, and economic and
non-economic damages. The bill requires the report to be filed with the
Maryland Insurance Commissioner, in addition to the other recipients of the
report. For hospitals, the other
recipient of the report is the Department of Health and Mental Hygiene. The
bill imposes a penalty of up to $5,000 for failure to report to the
Commissioner as required. The statute
already provides for a civil penalty of up to $5,000 for failure to report to
the other recipients.
Effective Date:
June 1, 2005
For more information, please contact: Heather Barthel
HB0157 Health Care Malpractice Claims -
Collateral Sources
This bill amends §3-2A of the Courts and
Judicial Proceedings Article by adding to the definition for noneconomic damages as follows:
"NONECONOMIC DAMAGES" MEANS:(1) IN
A CLAIM FOR PERSONAL INJURY, PAIN, SUFFERING, INCONVENIENCE, PHYSICAL
IMPAIRMENT, DISFIGUREMENT, LOSS OF CONSORTIUM, OR OTHER NONPECUNIARY INJURY; OR
(2) IN A CLAIM FOR WRONGFUL DEATH, MENTAL ANGUISH, EMOTIONAL PAIN AND
SUFFERING, LOSS OF SOCIETY, COMPANIONSHIP, COMFORT, PROTECTION, CARE, MARITAL
CARE, PARENTAL CARE, FILIAL CARE, ATTENTION, ADVICE, COUNSEL, TRAINING,
GUIDANCE, OR EDUCATION, OR OTHER NONECONOMIC DAMAGES AUTHORIZED UNDER SUBTITLE
9 OF THIS TITLE.
The bills also alters how an arbitration
panel or a trier of fact shall itemize an award to
reflect the amount for the following: (1) past medical expenses, (2) future
medical expenses, (3) past loss of earnings, (4) future loss of earnings, (5) noneconomic damages, (6) in wrongful death action the pecuniary loss or benefit,
and (7) other damages. The bill also
adds that if the arbitration modifies or corrects the award for damages for
past medical expenses, they must do so less the cost to obtain the payment,
reimbursement, or indemnity. It does not
apply to sums paid or payable for past medical expenses.
Effective Date:
June 1, 2005
For more information, please contact: Heather Barthel
HB0157 Health Care Malpractice Claims -
Collateral Sources
This bill, introduced by the Administration,
provides comprehensive medical liability reform, including some significant
tort reform, and amends portions of HB 2 of the special session. To follow is a summary of the components of
the legislation.
Itemization
of Award – an arbitration
panel or trier of fact shall itemize the award to reflect
the applicable amount attributable to: (1) past medical expenses, (2) future
medical expenses, (3) past loss of earnings, (4) future loss of earnings, (5)
past pecuniary loss, (6) future pecuniary loss, (7) other past economic
damages, (8) other future economic damages, (9) past noneconomic
damages, and (10) future economic damages.
Cap
on Non-economic Damages - Lowers the
cap on non-economic damages from $650,000 to $500,000; eliminates the $15,000
annual escalator due to resume in 2009; and provides for a single cap in
wrongful death cases instead of the 125% cap enacted by HB 2 of the Special
Session.
Collateral
Source - Allows evidence that a
person will be compensated from a collateral source (e.g., governmental
programs, insurance policies) to be considered when awarding damages.
Consideration must also be given to the cost incurred by the person claiming
damages in obtaining the collateral source.
Tax
Consequences of Lost Salary Damages
- Since these awards are not subject to taxation, the bill requires any award
for lost salary be reduced by the income tax that would have been paid.
Future
Medical Bills - Requires that future
medical expenses shall be paid at the Medicare rate of reimbursement. Future medical expenses for hospital facility
services will be based on HSCRC rates.
Mandatory
Neutral Expert - Requires the court
to appoint a neutral expert witness to testify on the issue of the plaintiff or
claimant’s economic damages and periodic payments. The cost of the Neutral Expert shall be divided
equally among the parties.
Periodic
Payments - Requires that awards or
judgments for future medical bills and lost wages for more than $100,000 be
paid by means of periodic payments, based on proposals submitted by each party
and the neutral expert appointed by the court. A proposal may recommend
purchase an annuity or annuities. The court will then select the best proposal
based on the needs of the plaintiff or claimant, along with any appropriate
modifications.
Expert
Witnesses - Provides that a health
care provider who attests in a certificate of qualified expert may not devote
annually more than 20% of their professional activities to activities that are
unrelated to the care or treatment of a patient and lead or could lead to
testimony in personal injury claims.
Daubert Rule - Establishes the Daubert rule in the State,
based on a U. S. Supreme Court case establishing standards for determining
admissibility of expert testimony.
Testimony
as Practice of Medicine - Makes an
Expert Witness subject to the rules, regulations, and orders of the Board of
Physicians. The Board may reprimand or
take disciplinary action against an Expert Witness.
Number
of Jurors/Judgment Interest -
Establishes that there will be at least six jurors in a civil case. Current law
allows six jurors only. Also, in civil cases the bill will provide that the
legal rate of interest will be based on the one-year Treasury Bill rate, rather than the current 10% rate.
Insurance - Repeal provision enacted by HB 2 of the Special
Session requiring MedMutual to sell directly to
physicians and the 5% limit on commissions paid by MedMutual.
Effective Date:
June 1, 2005
For more information, please contact: Heather Barthel
SB0143
Courts – Certificate of Merit – Employer of
Licensed Professional
This bill amends §3-2C of the Courts and
Judicial Proceedings Article - Malpractice Claims Against
Licensed Professionals. It adds to the
definition of a "Claim" that it is not only an action filed against
the licensed professional but also if it is filed against the employer of a
licensed professional.
Effective Date:
June 1, 2005
For more information, please contact: Heather Barthel
STAFF CONTACT INFORMATION
Please contact Government Relations if you have concerns or would like
additional information. Your input assists us greatly in evaluating and formulating
the position of Johns Hopkins on all legislation.
Legislative Session Office
410-269-0057
fax 410-269-1574
Heather Barthel hbarthel@jhmi.edu
Mickey Geisler mgeisler@jhu.edu
Matt Greenwood gcpa2@jhu.edu
Sheila Higdon shigdon@jhmi.edu
Jim Kaufman jkaufma@jhmi.edu
John Safapour ssafapou@jhsph.edu
Bret Schreiber bschreiber@jhu.edu
Cathy Ximenez cximenez@jhmi.edu
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Johns
Office of Government, Community and Public Affairs.