BOARD OF PHYSICIAN QUALITY ASSURANCE
The Board of Physician Quality Assurance (BPQA), the body that licenses and regulates physicians in Maryland, will
cease to exist as of June 30, 2003, if legislation is not passed during this Session. Senate and House bills were
introduced during the 2002 Legislative Session that would have significantly changed the current state of BPQA; neither
bill passed because of an inability to negotiate the major components of the proposed bills.
Three bills have been introduced this year, two of them by Delegate John Hurson, Chair of Health and Government Operations
Committee. The bills were heard before the House Health and Government Operations Committee last week. One of the bills,
introduced at the request of the Department of Health, will merely extend the sunset of BPQA and would retain it in its
current state. That bill generated very little discussion. The majority of the hearing centered on provisions of
House Bill 791 that would do the following:
1) Eliminate Med Chi as the peer review body; although it does not prevent Med Chi from competitively bidding to
conduct peer review,
2) Repeal the provision that factual findings will be supported by clear and convincing evidence (reduces them to
preponderance of evidence),
3) Increase Board membership to 21; add consumer members; Chair would be elected by Board as opposed to
being appointed by Governor.
Med Chi testified at the hearing and made the points that whatever entity is performing peer review should be
a not-for-profit agency, and that physicians performing peer review should be licensed in Maryland. Committee
members asked if Med Chi would object to more than one agency performing peer review, and asked if there would
be objection to physicians in the Washington, D.C. area performing peer review. Med Chi responded that there
was no objection in either case.
The issue of the Board composition was also addressed by Med Chi. Their primary concern was that the legislation
should not determine which medical specialties should be represented on the BPQA; and, that the Governor should
continue to appoint the Board Chair. Med Chi also recommended that Board appointments be made by the Governor,
but with the advice and consent of the Maryland General Assembly.
An issue that continues to generate dissention and discussion is the provision of the bill that changes the provision
that factual findings be supported by clear and convincing evidence. Although other health professionals are governed
by the lesser "preponderance of evidence", Med Chi and others contend that the standard should be raised for all
health professionals to the "clear and convincing" standard, which is also the standard for attorneys in Maryland.
The Senate will hear its version of the bill on Wednesday, March 5, 2003, in the Education, Health, and Environmental
Affairs Committee.
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BILLS INTRODUCED
Bond Bills
Economic Development
General Education
General Health Care
Health Care Facilities
Health Care Practitioners
Higher Education
Medicaid
Mental Health
Public Health
Miscellaneous
BILLS INTRODUCED
Bond Bills
HB0751
Creation of a State Debt - Washington Adventist Hospital
This bill authorizes the creation of a State Debt in the amount of $700,000. The proceeds will be used as a grant
to the Board of Directors of Washington Adventist Hospital for the planning, design, renovation, expansion,
repair, construction, and capital equipping of the hospital's Emergency Department.
Effective Date: June 1, 2003
For more information, please contact:
Bret Schreiber
HB1078
Creation of a State Debt - Baltimore City - Baltimore Medical System
This bill authorizes the creation of a State Debt in the amount of $1,000,000. The funds will be used as a grant
to the Board of Directors of Baltimore Medical System, Inc. for the reacquisition of the Baltimore Medical System's
Belair Road Family Health Center to relocate the current community health center and expand services, located
in Baltimore City.
Effective Date: June 1, 2003
For more information, please contact:
Bret Schreiber
[ Go to Bills Introduced]
Economic Development
SB0715
Minority Business Enterprises - State Contracts
This bill requires specific units of State government to comply with provisions regarding State procurement from
minority business enterprises. The bill also establishes a Minority Business Enterprises Goal Waiver Panel;
authorizing the Panel to grant waivers to units of State government from attaining specified procurement goals of
the Minority Business Enterprise Program (MBEP). Each unit of government unable to meet these goals will be
needed to seek a waiver to be excluded from the requirements.
Effective Date: October 1, 2003
For more information, please contact:
Bret Schreiber
[ Go to Bills Introduced]
General Education
HB1094
Sales and Use Tax - Rate - Education Trust Fund
This bill increases the sales and use tax from 5% to 6%. The bill also creates an Education Trust Fund. The
Comptroller will be required to distribute 8.3% of the sales and use tax revenue to the Education Trust Fund, and
8.3% of the sales and use tax revenues to the Transportation Trust Fund. The bill authorizes the use of money
from the Education Trust Fund for the implementation of the Bridges to Excellence in Education Act otherwise
known as the Thorton Commission recommendations.
Effective Date: July 1, 2003
For more information, please contact:
Bret Schreiber
[ Go to Bills Introduced]
General Health Care
HB0761
Task Force to Study the Reorganization of the Department of Health and Mental Hygiene
This bill establishes the Task Force to Study the Reorganization of the Department of Health and Mental Hygiene
(DHMH). The primary objective of the Task Force is to study ways to improve the delivery of health and mental
health services in Maryland. Included in this mandate are calls for specific studies on the structure of DHMH, the
impact of removing the Developmental Disabilities Administration, the Mental Hygiene Administration and the
Maryland Medical Assistance Program from the Department, and the organization of health departments in other
states.
The bill establishes a Task Force of 13 members comprised from the following organizations:
1) Two members from the Senate of Maryland,
2) Two members from the House of Delegates,
3) Three representatives from the DHMH,
4) One representative from the Department of Budget and Management),
5) One local health officer appointed by the DHMH,
6) One representative from the Association of Maryland Hospitals and Health Systems,
7) One representative from the Mental Health Association of Maryland,
8) One representative from the Maryland Association of Nonprofit Organizations (MANO), and
9) One individual with expertise in reorganization of State agencies.
The Task Force is required to report its findings to the Governor and the General Assembly on or before December
1, 2004.
Effective Date: October 1, 2003
For more information, please contact:
Beth Chaney
[ Go to Bills Introduced]
Health Care Facilities
HB1065
Health Services Cost Review Commission - Appointment of Members
The bill states that the Governor shall give priority to geographic areas of the State that are not represented, or
underrepresented on the commission when making appointments to fill a vacancy due to the expiration of a
member's term.
Effective Date: October 1, 2003
For more information, please contact:
Jim Kaufman
SB0612
Health - Ambulatory Surgical Facilities - Definition and Regulation
This bill changes the definition of an Ambulatory Surgical Facility to be a center, service, office, facility, or other
entity that operates primarily for the purpose of providing surgical services to patients requiring a period of
postoperative observation not exceeding 23 hours. The previous definition stated that the facility require
postoperative observation that did not require overnight hospitalization. The bill also gives the Office of Health
Care Quality (OHCQ) regulatory oversight of the 23-hour recovery care that occurs in Ambulatory Surgical
Facilities. Along with the oversight, the OHCQ would be required to submit a report to the House Health and
Government Operation Committee (HGO) and the Senate Finance Committee (FIN) annually regarding the number
of facilities providing 23-hour recovery care, and the types of services being provided by ambulatory surgical
facilities. The bill has been assigned to the Senate Rules Committee.
Effective Date: October 1, 2003
For more information, please contact:
Kate Bishop
SB0732
Hospice Care
This bill prevents the Maryland Health Care Commission from granting a person that operates a hospice program
from receiving a statewide Certificate of Need or authority to operate the hospice care program statewide through
a commission ruling or determination.
Effective Date: October 1, 2003
For more information, please contact:
Jim Kaufman
[ Go to Bills Introduced]
Health Care Practitioners
HB0441
Optometrists - Quality Eye Health Improvement Act
This bill alters current statute regulating the practice of Optometry. This bill would allow a licensed Optometrist
to use the word Doctor or the abbreviation of Dr. in his title. It changes the certification procedures to become a
licensed Optometrist to require current CPR certification, graduation from an accredited school of Optometry
within the past three years, the completion of 110 hours of continuing education in treatment and management of
Ocular disease within the past three years, or the possession of an active license for therapeutic Optometry in
another state immediately before the application for license in Maryland. The bill also extends the list of
medications that a therapeutically certified Optometrist may prescribe to include oral antibiotics, oral
antihistamines or decongestants, oral glaucoma medication and oral class three analgesics. In addition to
these changes, the bill also removes contradictory and repetitive language from the statute to clarify the existing
law.
Effective Date: October 1, 2003
For more information, please contact:
Beth Chaney
HB1039
Maryland Health Care Commission - Fees - Health Care Practitioners
This bill excludes registered nurses (except advanced practice nurses), licensed practical nurses and nursing
assistants from being assessed fees by the Maryland Health Care Commission (MHCC).
Effective Date: October 1, 2003
For more information, please contact:
Sheila Higdon
HB1099
Trauma Center Physician Services Funding Act
The bill establishes the Maryland Trauma System Fund, which will be supported by $250 fines for drivers who are
convicted of driving intoxicated, or under the influence of alcohol. The fund, will be administered by the Maryland
Health Care Commission (MHCC) in conjunction with the Maryland Health Services Cost Review Commission
(HSCRC).
The purpose of the fund is to subsidize the documented costs of physician uncompensated care provided to
trauma patients, reported on the trauma registry, cared for in a designated trauma center. The following trauma
centers as designated by the Maryland Institute for Emergency Medical Services Systems, are eligible to
participate:
1) The Primary Adult Resource Center,
2) Level I,
3) Level II,
4) Level III,
5) Pediatric Trauma Center.
Proceeds from the fund will be distributed based on a methodology established jointly by the MHCC and the
HSCRC to physicians who are required to apply to the fund on a form and manner determined by the Commission.
The allocation methodology is to take into account:
1) The amount of physician uncompensated care provided,
2) The number of patients served,
3) The number of Maryland residents served,
4) The extent to which physician uncompensated care costs are otherwise subsidized by the hospitals, federal
government, and other sources.
MHCC and the HSCRC are required to report annually to the General Assembly on:
1) The amount of money in the fund,
2) The amount of money applied for by eligible physicians,
3) The amount of money distributed in the form of physician reimbursements,
4) Recommendations altering the manner in which trauma physician uncompensated care costs are
reimbursement.
Effective Date: Emergency Measure (effective upon enactment)
For more information, please contact:
Jim Kaufman
[ Go to Bills Introduced]
Higher Education
HB0692
Consumer Protection - Privacy of Social Security Numbers
This bill would prohibit a person from publicly posting or displaying an individual's Social Security Number (SSN)
on a card required (for the individual) to access products or services provided by the person. It prohibits a person
from transmitting the number over the Internet unless the connection is secure or encrypted. It also seeks to
ensure that in order to use a SSN over the Internet, one must have a security number to access the Internet site,
or another password or unique identifying number. It does not allow a SSN to be placed on anything mailed to an
individual. The bill does not apply to the use of a persons SSN for the purpose of meeting a legal requirement
mandating the use of a SSN.
Effective Date: January 1, 2004
For more information, please contact:
Bret Schreiber
[ Go to Bills Introduced]
Medicaid
HB0630
Medical Assistance Program - Employed Persons with Disabilities Program
This bill changes current regulations regarding the Maryland Medical Assistance Program (MMAP) to grant
eligibility to some working individuals with disabilities. The bill is designed to allow disabled individuals who are
employed yet earn an annual income no greater than 300% of the federal poverty level to enroll in the MMAP. To
be eligible, the individual must not possess total assets of more than $10,000, must pay all applicable premiums
required in the Program, and must be between the ages of 16 and 64. The bill requires the Department of Health
and Mental Hygiene to administer the Program, and to report annually to the legislative policy committee regarding
the progress of the Program.
Effective Date: July 1, 2003
For more information, please contact:
Beth Chaney
SB0709
Department of Health and Mental Hygiene - Managed Care Organizations - Specialty Care Networks
The bill requires the Department of Mental Hygiene (DHMH) to adopt regulations, in consultation with Managed
Care Organizations (MCOs), providers, and advocates, that:
1) Establish measure standards for adequacy of and access to specialty care networks,
2) Require MCOs to maintain specialty care networks that meet the measurable standards,
3) Require DHMH to continuously monitor the MCOs compliance,
4) Establish consequences for MCOs that fail to maintain an adequacy specialty network,
5) Require MCOs to develop a process that allows an enrollee access to out-of-network specialists in the event
that an in-network provider is not within 30 miles of the enrollee's residence,
6) Require MCOs to allow enrollees to see an out-of-network provider in the same timeframe as in-network provider,
and
7) MCOs must ensure out-of-network claims are paid as required under Section 15-1005 of the Insurance Article,
the prompt pay statute.
Finally, the bill requires DHMH to report to the General Assembly beginning October 1, 2003 and every six-months
thereafter on the adequacy of the HealthChoice specialty care provider network.
Effective Date: June 1, 2003
For more information, please contact:
Jim Kaufman
[ Go to Bills Introduced]
Mental Health
HB0895
Mental Health - Individuals in Facilities - Use of Restraints and Seclusions
This bill amends current statute regarding the use of restraints on mental health patients and establishes a Task
Force to evaluate the use of restraint and seclusion in mental health facilities. The bill prohibits certain types of
restraints, including those that place a patient face down, impair a patient's ability to breathe, or restrict a
patient's ability to communicate. Restraint is to be used only when a patient's behavior creates an immediate risk
of violence, or injury to himself and/or others.
In addition to these new regulations, the bill establishes the Task Force on the Use of Restraint and Seclusion in
Mental Health Facilities and Programs. The purpose of this Task Force is to review and propose policies and
regulations regarding the use of restraint and seclusion as well as to evaluate current Mental Hygiene
Administration policies, and to make recommendations to reduce the use of restraint and seclusion, in all mental
health facilities in the State. The 12 member Task Force must conduct the review and present its findings to the
Governor and the General Assembly by June 30, 2004.
Effective Date: July 1, 2003
For more information, please contact:
Beth Chaney
SB0713
Mental Hygiene Administration - Emergency Evaluation - Petition, Standards, and Content
This bill adds an employee of a correctional facility in which an individual is confined to those who may petition
for an emergency evaluation of individuals with mental disorders. It also modifies current standards for
involuntary admissions of individuals with mental disorders, authorizing additional criteria on which an individual
making a petition for emergency evaluation to base the petition. This includes observation of the individual, their
behavior, or other pertinent factors. The bill also amends existing language in the petition that refers to the
evaluee's potential danger to their own life or safety, or that of others.
Effective Date: October 1, 2003
For more information, please contact:
Sheila Higdon
[ Go to Bills Introduced]
Miscellaneous
HB0620
Housing - Community Legacy Program - Neighborhood Intervention Projects
This bill redefines a neighborhood intervention project as a project sponsored by a Community Development
Financial Institution (CDFI). This bill would assist owner-occupants, community development organizations, or
local governments to buy and redevelop property that needs rehabilitation and is located in an otherwise stable
neighborhood. Redevelopment includes rehabilitation, demolition, reconstruction, or reuse. The funds may also
be awarded to a local government for the purpose of demolishing improvements on a property that are dangerous
for use or occupancy, deteriorated to the point that rehabilitation is not possible, and located in an otherwise
stable neighborhood.
The bill allows CDFIs to sponsor community legacy projects and directs the Community Legacy Board (CLB) to
give priority to project applications that provide for likely repayment of the financial assistance to a CDFI, or to the
Community Legacy Financial Assistance Fund (CLFAF). It also authorizes the Board to waive the requirements
for a community legacy area designation and a community legacy plan for neighborhood intervention projects.
It also creates a Neighborhood Intervention Fund (NIF) within the CLFAF and requires the board to allocate at
least 15% of the CLFAF to the NIF. The fund consists of:
1) Money appropriated in the State budget,
2) Investment earnings,
3) Repayments of loans provided for neighborhood intervention projects,
4) Money allocated by the board, and
5) Any other money from any source accepted for the fund's benefit.
Sponsors of NIF-funded projects must agree to use the financial assistance and any repayments and
prepayments primarily to make loans to owner-occupants, community development organizations, or local
governments to buy and redevelop property that needs rehabilitation and is located in an otherwise stable
neighborhood. They must also agree to repay the financial assistance to the CLFAF up to the amount received
from the net proceeds of the sale of the property on which the demolition took place or any payment to the sponsor
for the costs incurred in demolishing improvements on the property.
Effective Date: July 1, 2003
For more information, please contact:
Bret Schreiber
HB0741
Community Associations - Civil Liability
This bill would add "community associations" to the list of organizations covered by the Maryland Associations,
Organizations, and Agents Act, which provides limits on liability of organizations that carry specific insurance
minimums. The bill defines community association as a nonprofit entity that promotes social welfare and
general civic improvement, and is registered with the Secretary of State. The bill authorizes nonprofit entities that
have been in existence for at least five years and promotes social welfare and general civic improvements, to
register with the Secretary of State as a community association.
Effective Date: October 1, 2003
For more information, please contact:
Bret Schreiber
[ Go to Bills Introduced]
Public Health
HB0589
Lead Poisoning - Risk Reduction Standards - Exemption
This bill would exempt outside surfaces of property (windows, trim, fences, etc.) from the risk reduction standards,
if an owner submits a report (verified by the Maryland Department of the Environment inspectors) to MDE that the
surfaces have been tested for lead-based products and are lead-free.
Effective Date: October 1, 2003
For more information, please contact:
Jason Spangler
HB0714
Reduction of Lead Risk - Qualified Offer - Housing Subsidy
This bill would expand lead-safe housing to include an owner-occupied dwelling that meets the Maryland
Department of the Environment's (MDE) lead-safe standards; expand relocation expenses to include down
payments, earnest money, and closing costs; change rent subsidy language to "housing" subsidy and expand this
to include the mortgage payment of the relocated property; and require a person that uses qualified offer funds for
purchasing a house to complete budgeting, credit issues, and housing affordability counseling with a tax-exempt
non-profit that is certified by US Dept. Housing and Community Development.
Effective Date: October 1, 2003
For more information, please contact:
Jason Spangler
HB0719
Department of the Environment - Paint Retailers - Brochures on Lead Risk Reduction
This bill would require paint retailers to distribute (to consumers) a lead poisoning education brochure provided
by the Maryland Department of the Environment (MDE). The brochure must include:
1) Dangers and hazards of lead poisoning,
2) Lead risk reduction measures,
3) Safe renovation practices, and
4) State resources available for lead risk reduction.
Effective Date: October 1, 2003
For more information, please contact:
Jason Spangler
HB0720
Real Property - Repossession by Landlord - Lead Poisoning Requirements
This bill would require a landlord who wants to repossess any premises must state that the lead poisoning
requirements (property registration and risk reduction standards) of the environment article in the Annotated Code
have been satisfied.
Effective Date: October 1, 2003
For more information, please contact:
Jason Spangler
HB0722
Environment - Report by Local Government Agency - Noncompliance with Lead Risk Reduction Provisions
This bill would require a local government agency to report to the Maryland Department of the Environment (MDE)
any non-compliance of lead risk reduction of an affected property.
Effective Date: October 1, 2003
For more information, please contact:
Jason Spangler
HB0819
Education - Lead Poisoning Tests - Administering and Reporting
This bill would change a few items regarding testing for lead poisoning in children. The bill would have the
Department of Health Mental Hygiene (DHMH) cooperate with the Maryland State Medical Society (MSMS) (instead
of the Statewide Advisory Commission on Immunizations) regarding blood tests for lead poisoning required of
children entering school. The bill would also require the parent or guardian to provide actual documentation on a
DHMH form from a physician to confirm the testing, and schools to provide contact information (name, address,
and phone number) for those children that don't have the documentation.
Effective Date: July 1, 2003
For more information, please contact:
Jason Spangler
SB0624
Medical Assistance Programs - Long-Term Care Services
This bill establishes a more complete definition of who will be eligible to enroll in Medicaid nursing facilities.
The bill would require DHMH to designate a "single entry point," one in each county and Baltimore City, that would
accept applications, enroll individuals, perform case management, and develop a plan of care. In conjunction,
the bill asks for the development of a state-wide system to accept applications, enroll patients, and otherwise
coordinate the program. This would include an automated provider licensure and inspection system. All providers
would then bill the department directly for any services provided under the waiver.
While asking the DHMH to apply for a Home and Community-based long term waiver (1915-c) as has been done
since 1997, DHMH would be required to file for a managed care waiver (1915-b), requiring long-term and
community-based care Medicaid patients to enroll in a managed care program.
Effective Date: July 1, 2003
For more information, please contact:
Kate Bishop
[ Go to Bills Introduced]
