Legislative Hotline
2007 SESSION OF THE
MARYLAND GENERAL ASSEMBLY
Volume
14, Number 10����������������������������������������������������������������������������������������������������������������������������� April 13, 2007
�2007 Legislative Session Sine Die Report
Johns
At midnight on April 9, the
Maryland General Assembly adjourned sine
die.� In this first session of a
four-year term, major budget initiatives were avoided:� on the one hand, legislators were reluctant
to consider tax increases too soon after an election and wanted to give
Maryland’s new governor the time he requested to learn how Annapolis
ticks and seek out inefficiencies in state government before developing any
comprehensive legislation; and on the other, not wanting to move major new
spending measures with the state facing a structural deficit of nearly $1.5
billion and news of declining revenues.�
Nevertheless, it was an exciting session and a busy one for Johns
Hopkins as legislation affecting health care and hospitals took center stage
and progress was made on several key priorities.
But first, a word of thanks
To everyone who helped us during this session,
especially to those who came to Annapolis to testify in front of committees or
meet with lawmakers on behalf of Johns Hopkins, please accept our deepest
appreciation for your time and expertise.
Looking Back…�
Here’s a look at the 2007 session as it impacts Johns
HEALTH CARE FACILITIES & PRACTITIONERS
MEDICAL LIABILITY & TORT REFORM
ECONOMIC & COMMUNITY DEVELOPMENT
The General Assembly passed
the state budget on April 9, a week behind schedule and leaving until the last
day of session the passage of a balanced budget.� The unusual delay stemmed in part from the
state’s looming budget crisis which made debate particularly contentious,
but in the end lawmakers passed a $30 billion operating budget bill that was
very close to that proposed by the Governor, with total reductions of over $229
million.
Sellinger Aid:� $25
million for Johns
The Governor’s budget included $58.6 million of
unrestricted Sellinger Aid for private institutions
of higher education, with $25 million for Johns Hopkins.� The House cut $1 million from the Sellinger Program by limiting the annual increase to 15%,
but the final budget restored full funding to the program.
Cigarette
Restitution Fund:� $3.7 million for Johns
Johns
Hopkins CRF funds include a $2.5 million cancer research grant and a $1.2
million public health grant.
Physician
Reimbursement:� $40 million increase
This rate enhancement represents the third year of
the four year initiative to raise Medicaid physician payment rates to 100% of
Medicare.
Funding
for stem cell research became a particular sticking point in the budget debate
during the final days of the 2007 session.�
The House supported full funding of Governor O’Malley’s $25
million request, but the Senate cut the funding to $15 million, the amount in
last year’s budget.� In the
conference committee, lawmakers agreed to a compromise of $23 million.� (Award decisions for FY 2007 funds were
expected in March, but are now expected following the next meeting of the Stem
Cell Research Commission on April 25.)
Phase Out
of
Governor’s proposed
budget eliminated Medicaid day limits.�
The House reinstated day limits for another year with a $26 million cut,
while the Senate made only a $13 million cut.�
In conference, compromise was reached with a $17.2 million reduction
with the phasing out of hospital limits in six to eight months.� Hospital day limits cap the number of days
that Medicaid will pay for an adult hospital stay up to 120% of the average
length of stay by diagnosis-related groups.
Medicaid Funding
In the area of Medicaid
funding, the conference committee rejected the $9 million reduction in MCOs payments that was proposed by the House.
The General Assembly passed
a capital budget of over $800 million on April 9, following passage of the
operating budget.� As Governor
O’Malley promised during his gubernatorial campaign, public school
construction is a top priority in the FY 2008 capital budget,
with over $385 million in capital funding that consumes nearly half of total
budget dollars (an additional $15 million in operating funds takes the total to
$400 million).� The budget includes the
following capital projects for Johns Hopkins.
Cardiovascular
and
Gilman Hall
Renovations:� $2 million
In addition, the following
capital projects in the budget are of interest to Johns Hopkins:
|
East Baltimore
Development, Inc. for |
$ |
5,000,000 |
|
|
|
$ |
5,000,000 |
(includes the Bayview expansion) |
|
Adventist Healthcare |
$ |
�� 120,000 |
Shady |
|
|
$ |
�� 700,000 |
Primary Care, Diabetes,
Pulmonary &Child Sexual Assault Services |
|
|
$ |
1,000,000 |
Intensive Care Unit
renovation |
|
|
$ |
�560,000 |
ED renovation |
|
Shore Health System |
$ |
�500,000 |
Dorchester General ED
renovation |
|
|
$ |
� 560,000 |
Birthing Center/NICU
renovation |
|
|
$ |
1,000,000 |
New Obstetric Unit |
Expanding
Health Care Access
Task Force on Health Care Access &
Reimbursement (passed)
This administration bill was
requested by MedChi, the Maryland State Medical
Society, in response to low provider reimbursement rates.� Unlike hospitals, physicians do not recoup
any of their uncompensated care expenses through
Senate and House Bills (failed)
This session was to be the
year of health care expansion.� An
extensive plan to expand Medicaid coverage to more than 100,000 uninsured
funded by a $1-a-pack increase in the tobacco tax moved easily through the House,
but was never brought to the Senate floor because of the opposition in the
Senate.� Nevertheless, several
initiatives appeared throughout various proposals, providing a preview of the
areas on which there is likely to be an emerging consensus and where reform
will likely coalesce over the course of the next year:
- Expansion of Medicaid/Children’s Health
Insurance Program
- Coverage for dependents under age 25 on the
parents’ policy
- A health insurance exchange
- Wellness programs: Separate legislation passed authorizing
discounts of up to 20% in the small group market for participation in a
wellness program.� Another bill that
passed allows health insurance carriers to provide incentives for
participation in wellness programs.
- Individual responsibility: Separate legislation passed requiring
the Maryland Health Care Commission (MHCC) to study the issue of personal
responsibility for obtaining health care coverage.� Income tax surcharge on higher income
individuals who choose not to purchase health insurance was among the
provisions in the failed House bill.
Health Care Facilities &
Practitioners
There was a greater sense of
urgency this session to find a long-term, sustainable solution to the financial
crisis facing
Health Services Cost Review Commission
(HSCRC) Sunset Extension and Evaluation (passed)
This legislation implements several recommendations
of the October 2006 “sunset review,” and moves forward the date of
its next program evaluation to July 1, 2017.�
The bill increases the cap on hospital user fees from $4 million to $5.5
million, in keeping with recommendations to allow for sufficient budgetary
growth through FY 2011.� The bill also
requires HSCRC’s annual report to include an
update on the status of the state’s Medicare waiver and a summary of HSCRC’s role in hospital quality of care activities.
This legislation also implements several
recommendations of the October 2006 “sunset review,” and moves
forward the date of its next program evaluation to July 1, 2017.� The bill increases the commission’s
user fee cap from $10 million to $12 million.�
The bill makes several changes to commission operations and funding,
requires several studies and reports, and authorizes MHCC to collect data on
payments to hospitals.� The Senate passed
a separate bill altering the membership composition of the fifteen-member MHCC
to include a hospital administrator.�
However, because the House did not act on that legislation, it failed.
Legislation passed removing
the Executive Director of the Maryland Institute for Emergency Medical Services
Systems (MIEMSS) from the Board of Directors of the
MCOs Retroactive Denial of Claims and
Applicability of State Laws (passed)
This bill provides that Medicaid MCOs
are subject to the same restrictions on retroactive denial of claims that apply
to commercial insurance companies and clarifies that MCOs
are not subject to state insurance laws with the exception of insurance
provisions that are specifically applied to all MCOs.� The bill also permits an MCO to retroactively
deny a claim submitted for services provided to a Medicaid enrollee during a
time period for which DHMH has permanently retracted the capitation payment for
the recipient from the MCO.
Higher
Education
Review of Duplicative Academic Programs (failed)
A bill that would have
allowed
Plans for Programs of Cultural
Diversity (failed)
This bill would have
required nonpublic institutions of higher education to submit an annual report
on their programs to promote and enhance cultural diversity.� This measure easily passed the Senate but was
stalled in the House.
State Tuition Freeze (passed)
Legislation introduced by
the O’Malley administration passed prohibiting the Board of Regents of
the
Public
Health
Smoking Ban (passed)
Passage of a ban by the
Baltimore City Council in late February gave the smoke free initiative a big
boost of momentum, which has ended with the passage of one of the strongest
smoking bans in the nation.� Initially,
the House and Senate passed different versions of the bill, with the Senate
giving exemptions to private clubs.� The
final compromise stipulated that waivers may be issued by local health
officials to businesses that can demonstrate a financial hardship, but these
waivers would expire by 2011 and not be renewable.� Governor O’Malley has pledged to sign
the bill, which will take effect February 1, 2008.
HIV Testing—Name-Based Reporting (passed) & Study on Revised CDC Guidelines (passed)
An emergency bill was passed
requiring Maryland to transition from code-based to name-based HIV reporting, a
measure made necessary by the reauthorization of the Ryan White CARE Act in
December 2006 which mandates name-based reporting as a necessary condition of
the nearly $65 million Maryland receives annually in federal funding.� To maintain the confidentiality of the
HIV/AIDS reports, this bill makes such information not discoverable or
admissible as evidence in a civil action and establishes stiff penalties for
any person who unlawfully discloses, requests, or obtains such
information.� Another HIV/AIDS bill
passed that requires the AIDS Administration to convene a work group to review
and make recommendations regarding the new CDC guidelines for HIV testing in
health care settings.� Revised in
September 2006, the guidelines recommend routine screening and, as a means to
this end, the elimination of statutory requirements for informed consent and
pre-test counseling.� The work group is
to include HIV infected individuals, HIV/AIDS advocacy organizations, HIV
service providers, and other stakeholders.
Statewide
Steering Committee on Services for Adults with Sickle Cell Disease (passed)
Legislation passed establishing the Statewide
Steering Committee on Services for Adults with Sickle Cell Disease to implement
some of the recommendations of the DHMH study of SCD in
Medical
Liability & Tort Reform
Repeal of Requirement for Expert Report (failed)
Introduced to overturn a
November 2006 Court of Appeals decision in the case of Walzer v. Osborne, this bill would have repealed the requirement that a
claim against a health care provider include a report of a qualified expert
attesting to departure from standards of care.�
The bill was strongly opposed by hospitals and health care
providers.� It passed out of committee
but received an unfavorable vote on the floor of the House; proponents tried,
but were unsuccessful in changing enough to file a motion for reconsideration.
Creation of a Medical Liability
Division (failed)
Several pieces of
legislation failed that would have authorized the establishment of, or studied
the feasibility of establishing, separate medical liability divisions in state
circuit courts.� Another bill failed that
would have required all medical liability actions to be referred to a medical
malpractice review board before being heard in court.
Inadmissibility of Apology (failed)
Failing again this session
was legislation to repeal the provision in Maryland that allows an apology or
expression of regret by a health care provider to an alleged victim or the
victim’s family to be admissible as evidence of admission of liability in
a medical malpractice lawsuit or arbitration proceeding.
Economic
& Community Development
The Governor’s bill
passed establishing a Maryland Life Sciences Advisory Board in the Department
of Business and Economic Development charged with developing a comprehensive
strategic plan for
Medical Research—Human Cloning
Prohibitions (failed)
A Senate bill that would
have expanded the prohibition against human cloning to include cells derived
from somatic cell nuclear transfer (SCNT) research received an unfavorable
report.
Minority Business
Several bills regarding procurement activities and
minority business enterprise (MBE) participation were debated this session,
though no committee action was taken on the measures.
Baby Boomer Initiative Act (passed)
This bill establishes the Baby Boomer Initiative
Council consisting of state officials and members of the business, education,
and aging communities.� As amended, the
council must include as a member, the Director of the
Consumer Protection
Personal Information Protection (passed)
A number of proposals aimed
at protecting consumers against identify theft were debated this session.� The legislation that passed requires
businesses to take measures to protect personal information and to promptly
disclose security breaches of personal data.
Environmental
Health
Legislation to improve air
quality in the state met with success this session.� Under this bill, the Department of the
Environment, in consultation with the Motor Vehicle Administration, must
establish a low emissions vehicle program applicable to vehicle model years
2011 and beyond.
Looking Forward…
Legislative leaders told
members of the General Assembly to keep their calendar free in September, and
it is widely believed that a special session will be called this fall for the
passage of comprehensive tax and revenue package and even, some legislators
have indicated, health care access expansion legislation.
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
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Jessica Best |
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Mickey Geisler��������� |
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Matthew Greenwood���� |
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Sheila Higdon��������� |
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Tom Lewis���������������� ����� |
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Nicole Xander |
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� 2007 The
Johns
Office of Government, Community and Public Affairs.