AGENDA FOR SECRETARY OF HEALTH AND MENTAL HYGIENE
Nelson Sabatini, the new Secretary of the Maryland Department of Health and Mental Hygiene, met with the Maryland Hospital Association's Legislative Committee on Friday March 14, 2003, to discuss his agenda. He focused on four core issues that he believes needs to be addressed.
1. Pharmacy - The Secretary plans to continue the efforts to develop a preferred drug list for enrollees in the Medicaid program. In addition, he plans to develop a supplemental rebate program that would allow pharmacy manufacturers who are not placed on the preferred drug list to reduce their costs in order to be added to the list. The supplemental rebate program is estimated to generate over $2 million in savings in the first year.
2. Children's Health Insurance Program - While Secretary Sabatini is opposed to reducing enrollment for the CHIP program, he feels the State cannot continue to afford these costs. Maryland has been successful in expanding Medicaid coverage, and he feels that the real issue is not reducing CHIP coverage, but ensuring that working families continue to have access to affordable health insurance.
3. Public Mental Health System - It was noted that the entire public mental health system needs to be overhauled. In addition to reducing the number of excess facilities, a review should be performed to determine how services are offered including privatizing services in the central Maryland region. Also, in order to address problems with Maryland Health Partners (MHP), the Secretary plans to seek a 6-month contract extension with MHP, whose contract expires in July, to provide sufficient time to bring this service back inside the Department.
4. Physician Reimbursements -To ensure that Medicaid enrollees continue to have access to care, the Secretary noted that increased Medicaid reimbursement rates are a critical issue for the Department. Hospitals have been forced to subsidize physicians, and while the HSCRC addresses hospital rates, they do not address the physician component.
BILLS INTRODUCED
Health Care Practitioners
Health Insurance
BILLS INTRODUCED
Health Care Practitioners
SB0734
Health Occupations - State Board of Social Work Examiners - License
This bill permits a Social Worker who is licensed in another state to practice Social Work in Maryland for up to six
months under the following conditions:
1. must possess Social Work qualifications comparable to what is required in Maryland,
2. has an application for licensure in Maryland pending before the Board of Social Work Examiners, and
3. meets regulations adopted by the Board.
Effective Date: October 1, 2003
For more information, please contact:
Nicole Xander
[ Go to Bills Introduced]
Health Insurance
HB1179
Nonprofit Health Service Plans - Reform
The intent of this bill is to regulate the formation and operation of nonprofit health service plans in the State of
Maryland, and to promote their existence. The bill also establishes a Joint Blue Cross and Blue Shield Oversight
Committee, that will require a nonprofit health service plan to report quarterly (on or before October 1, 2003
through October 1, 2006), on its performance and other agreed upon information as outlined by the Committee.
The Oversight Committee will be comprised of 15 members, appointed by the President of the Senate and
Speaker of the House, who shall appoint a Senator and Delegate to serve as Co-chairs. The membership of the
committee shall be:
1. two members of the Senate,
2. two members of the House of Delegates,
3. the owner of a business that employs more than fifty people,
4. the owner of a business that employs two to fifty people,
5. a representative of a Maryland labor organization,
6. a member with experience in nonprofit administration and operation,
7. a representative of the State Employee Health Benefit Plan,
8. a representative of a nonprofit health care advocacy association,
9. a representative of the Medical and Chirurgical Faculty of Maryland,
10. a representative of the Maryland Hospital Association, and
11. three members of the public.
The bill codifies the mission of the nonprofit health plan to:
1. provide health insurance at affordable prices for employer, group, and individual markets,
2. assist and support public health care initiatives for individuals without health insurance, and
3. promote the integration of a statewide health care system that meets the health care needs of all Maryland
citizens.
In addition to allowing a nonprofit health plan to satisfy the public service requirement by increasing access to or
the affordability of health insurance, the bill adds three new provisions for the public service requirement:
1. provide financial or in-kind support for public health programs,
2. employs underwriting standards that increase the availability of one or more health care service, and
3. employs pricing policies that enhance the affordability of health care services or products, that results in
higher medical loss ratios than that of established comparable for-profit health plans.
In addition to requiring the plan to administer and subsidize the Senior Prescription Drug Program, the bill also
requires the plan to offer a comprehensive benefit, open enrollment product in the individual market and small
group market.
The bill requires the health plan to submit as part of its application for a certificate of authority to the Maryland
Insurance Administration, articles of incorporation to include the plan's mission statement and a list of total
compensation paid or proposed to each member of the Board of Directors. The bill also codifies the function of
the Board to include:
1. carrying out the nonprofit mission of the plan,
2. monitoring the performance of the corporate management,
3. ensuring resources are sufficient to meet corporate objectives, and
4. selecting suitable candidates for the Board.
The bill establishes a Board that will be comprised of 15 members to include:
1. individuals with backgrounds in accounting,
2. information technology,
3. finance,
4. law,
5. large and small business,
6. nonprofit business,
7. organized labor, and
8. two consumers.
No more than 20% of its members shall be licensed health care professionals, hospital administrators, or their
employees. A member may not serve more than 2 full terms or 8 years. The bill also states that the
compensation, if any, for the Board of Directors and Officers of the plan shall be reasonable as determined by the
Insurance Commissioner, in comparison to the compensation paid to Board members and Officers of comparable
nonprofit plans in the United States.
Effective Date: July 1, 2003
For more information, please contact:
Jim Kaufman
[ Go to Bills Introduced]
