Johns Hopkins Institutions

Legislative Hotline

2007 SESSION OF THE
MARYLAND GENERAL ASSEMBLY

Volume 14, Number 9�� March 23, 2007

2007 SESSION FAILED LEGISLATION OF INTEREST

BILLS INTRODUCED
STAFF CONTACT INFORMATION

�Monday, March 26 is the Opposite Chamber Bill Crossover Date.� By this date each chamber is to send to the other chamber all bills it intends to pass favorably.

Johns Hopkins was successful in its opposition to a medical malpractice bill that would have repealed the requirement that a claim against a health care provider include a report of a qualified expert attesting to departure from standards of care.� The bill was passed out of committee but received an unfavorable vote on the floor of the House.� Following this, proponents of the bill attempted to have it reconsidered under a rule that allows such reconsideration within two legislative days of an unfavorable vote.� Thanks to the hard work of the Maryland Hospital Association, MedChi, and Johns Hopkins, proponents were unable to change enough votes for the bill to be favorably reconsidered.

On March 7, Johns Hopkins testified in support of a House bill that would create a task force to study the feasibility of establishing a medical liability division in circuit courts throughout the state.� Earlier Johns Hopkins had testified in support of a Senate bill that would authorize the establishment of such divisions.� The House bill on this subject received an unfavorable report.� However, no action has yet been taken by the Senate on their similar, but narrower version of the bill.

On March 6, Johns Hopkins testified in the Senate in opposition to legislation that would change the negligence liability standard in Maryland from a “contributory negligence” theory to a “comparative negligence” theory that would allow suits by plaintiffs who are partially at fault for their damages.� Passage of this bill would increase malpractice insurance premiums and broaden the liability exposure of hospitals and health care providers.� The House version of this bill was withdrawn on March 22 after a considerable amount of lobbying by Johns Hopkins and others as part of the “Tort Reform Coalition” of hospitals, businesses, and local governments.

The Senate has approved a bill that would allow judicial review in the circuit court of the 2005 Maryland Higher Education Commission vote approving a joint Towson-University of Baltimore MBA program.� Towson’s program is being targeted by officials at Morgan State University on the grounds of a 1992 Supreme Court case ruling that the establishment of academic programs at historically white colleges that are “unnecessarily duplicative” of those at historically black colleges perpetuates segregation.� The bill was introduced in a way that would affect all higher education institutions but was narrowed by amendment to address only the Towson/Morgan disagreement.� The House of Delegates has yet to consider the bill.

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On March 14, the House and Senate held hearings on a bill that would require Maryland to transition from code-based to name-based HIV reporting.� Johns Hopkins supports this emergency measure made necessary by the reauthorization of the Ryan White CARE Act in December 2006 that makes name-based reporting a necessary condition of the nearly $65 million Maryland receives in federal funding.

A bill has passed the Senate and is currently being considered by the House which, as amended by the Senate, requires the Department of Health and Mental Hygiene to authorize a freestanding emergency department project on Kent Island that is associated with and run by the University of Maryland Medical Center through Easton Memorial Hospital, although the text is more general and does not name a particular entity.� The bill, which tracks a current provision of law, would not prevent the opening of a primary health care center since primary care is not subject to Certificate of need (CON) requirements.� Since “urgent care” centers are not subject to CON either, opening an urgent care center would also not be prohibited by this bill.� This legislation mirrors the provisions of a bill passed last year for Shady Grove Adventist Hospital to allow them to open a freestanding emergency department tin Gaithersburg.

Two similar bills regarding personal information protection (H.B. 208 & S.B. 194) have passed the House and Senate and are now in conference committee.� The bills require business entities to take measures to protect the personal information in their possession and to provide notice to individuals if there is a reasonable belief that this information may have been compromised.� The Senate version of the bill provides an exception to businesses with less than $1 million in gross annual income.� Johns Hopkins’ response to the recent incident exceeded the requirements of both bills.� Johns Hopkins will continue to track these bills as they move through conference committee.

Hearings on Johns Hopkins’ capital project requests were held this week and last in the Senate Budget and Taxation Committee and the House Appropriations Committee.� Dr. Knapp and Tom Lewis testified in support of Gilman Hall renovations; Dr. Miller and Dr. Dover on behalf of the new clinical buildings in East Baltimore; and Mr. Schaffer for the Bayview Medical Center bond bill.� The House has approved the capital project appropriations as recommended in the Governor’s budget.� Senate decisions will occur early next week.

An amended version of the health care access bill sponsored by Delegate Pete Hammen and House Speaker Mike Busch passed the House last week.� Partially funded by doubling the tobacco tax to $2 per pack, the bill expands health insurance coverage to more than 100,000 uninsured Maryland residents, about half the number in the original bill.� Added to the legislation is the provision of $50 million over five years to Prince George’s Hospital System.� Subsidies to small businesses that offer health insurance coverage and an income tax surcharge on high income individuals who do not have insurance have been eliminated from the legislation.� The bill anticipates that there will be savings in hospital rates due to the expansion in Medicaid coverage for adults up to 116% of the federal poverty level (from the current level of 40%).� Those savings will result in some reduction to hospital rates beginning in FY 2010 (once short-term revenue from the MHIP fund surplus and the state’s med mal stabilization fund have been exhausted) and to an increase in Medicaid coverage in future years (after FY 2009).� The Senate is now considering the House bill, though the President has voiced his strong opposition to an increase in the tobacco tax which will severely limit any Medicaid expansion.

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An amended version of the Governor’s health care access bill has received a favorable report from the Senate Finance committee and awaits a vote by the full Senate.� Among the provisions in the revised bill is the expansion of the Children’s Health Insurance Program (CHIP) to families earning up to 350% of the federal poverty level, requiring insurance companies to cover dependent children up to age of 25 on the parents’ policy, creating a task force on establishing an insurance exchange for small business owners, establishing a Maryland Health Care Quality Coordinating Council, encouraging the use of wellness programs, and creating a task force on expanding access to affordable health care.�

The House unanimously passed emergency legislation that would establish the Prince George’s County Hospital Authority (PGCH), a state-appointed entity that would manage the hospital system, acquire its facilities, and transfer its ownership to another buyer.� Prince George’s County Council members have opposed the bill because of a provision requiring the county to pay off the hospital’s $150 million debt through property tax.� Support for the bill came just days after delegates learned of discussions between Prince George’s County Executive Jack Johnson and Doctors Community Hospital in Lanham to take over PGCH.� The O’Malley administration has recently announced its support of the bill which will have a hearing in the Senate next week.

The FY 2008 Budget Bill passed the House last week with amendments that reduced appropriations in the $30 billion bill and two supplemental budgets by over $190 million.� The Senate passed its version earlier this week, cutting appropriations by nearly $205 million.� Among the House reductions are a $30 million cut in the state portion of the Medicaid program which continues funding for hospital day limits and a $1 million cut in Sellinger Aid for private higher education institutions.� Under Governor O’Malley’s proposed budget, Johns Hopkins received an 18% increase in Sellinger Aid for FY 2008; the $1 million cut limits the increase to 15%.� Among the Senate reductions is a $10 million cut to the $25 million stem cell research fund requested by the Governor and approved by the House.� One House cut that affects Priority Partners directly is a $9 million cut to Medicaid MCOs affecting the current fiscal year.� The Senate did not take a cut in this area.� Final budget decisions will be made by the conference committee which begins deliberations at 3:00 p.m. on Saturday, March, 24; Monday, April 2 is the deadline for the budget bill to be passed by both chambers.

Johns Hopkins epidemiologist Lisa Maragakis testified on a panel with the Maryland Patient Safety Center in opposition to a Senate bill regarding health-care associated infections prevention and control programs.� The bill has received an unfavorable report.

This week the House and Senate held hearings on a safe patient lifting bill that is supported by the Maryland Hospital Association since it is essentially consistent with current Johns Hopkins practices.� The bill has received a favorable report by both committees.

On March 5, the governing board of Johns Hopkins Medicine voted unanimously in support of legislation that would ban smoking in all indoor public spaces in Maryland.� On March 7, a panel of Johns Hopkins experts, including Charles Rudin, Jonathan Samet, Heather Wipfli, and Hugh Waters, testified in support of the bill before the House Economic Matters Committee.� On March 15, Drs. Samet, Wipfli, and Waters testified again before the Senate Finance Committee.� The smoke free Maryland initiative gained significant momentum when the Baltimore City Council passed smoke free legislation on February 26.� Governor O’Malley has since announced that he would sign a statewide bill.

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The Senate Finance Committee voted in favor of a legislation banning smoking in all indoor public spaces on March 19, and the House Economic Matters Committee approved a similar measure the following day.� Unlike the House version, the version passed in the Senate makes exceptions for private clubs and fraternal organizations such as American Legions or VFWs, gives businesses the right to petition their local health officers for a financial hardship exemption, and amends the effective date until January 1, 2008.� Debate has moved to the full House and Senate where it is believed the bill has the necessary votes to pass both chambers.

Last week and this week the House and Senate held hearings on a bill that would establish a task force on the HPV vaccine to recommend a plan to implement a state HPV vaccine program.� Both bills have passed committee with an amendment that includes a Johns Hopkins representative on the task force.

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2007 Session Failed Legislation of Interest

� Maryland Assault Weapons Ban of 2007 (S.B. 43)

� Health—General—Vaccine for Prevention of Cervical Cancer (S.B. 54)

� Income Tax—Credit for Smoking Prohibition on the Premises of Business Establishments (S.B. 67)

� Health Care Malpractice—Expression of Regret or Apology—Inadmissibility (S.B. 84 & H.B. 147)

� Maryland Medical Assistant Program—Medical Day Care—Reimbursement Rates (S.B. 155 & H.B. 329)

� Income Tax—Research and Development Tax Credits—Modifications (S.B. 232)

� Labor and Employment—Leave with Pay—Illness of Employee’s Immediate Family (S.B. 260)

� Prescription Privacy Act (S.B. 266)

� Health Maintenance Organizations—Reimbursement Rates of Noncontracting Providers (S.B. 323)

� Public Schools—Summer Learning Pilot Program (S.B. 466)

� Food Service Facilities—Use of Artificial Trans Fat—Prohibition (S.B. 504, S.B. 633)

� Consumer Protection—Protection of Personal Information from Security Breaches (S.B. 514)

� Health Insurance—Visits After Diagnostic or Surgical Procedure Using Anesthesia—Coverage (S.B. 542)

� Health Insurance—Clean Claims (S.B. 583 & H.B. 848)

� First Responders Fund (S.B. 589)

� Health—Disclosure of Medical Records—Cases Before the Workers’ Compensation Commission (S.B. 599)

� Physicians—Delegation of Duties—Nonphysician Surgical Assistants (S.B. 610)

� Repeal of Certificate of Need Requirements—Health Care Facilities Other Than Home Health Agencies and Hospices (S.B. 628 & H.B. 1074)

� Health—Prohibition Against Smoking in Vehicle Containing Minor Passenger (S.B. 629)

� Health Insurance—Managed Care Organizations—Service Count Ratio (S.B. 648 & H.B. 411)

� Economic and Community Development—Community Technology Centers (S.B. 664)

� Prescription Drugs—Canadian Mail Order Plan (S.B. 670)

� Maryland Medical Assistance Program—Atypical Antipsychotic Medication (S.B. 729 & H.B. 913)

� Hospitals and Nursing Facilities—Health-Care Associated Infections Prevention and Control Program (S.B. 837)

� No-Fault Cerebral Palsy Insurance Fund (S.B. 881)

� Consumer Protection—Personal information Protection Act (S.B. 904 & H.B. 123, H.B. 90)

� Maryland Clean Cars Act of 2007 (H.B. 44)

� Circuit Courts—Medical Injury—Medical Malpractice Administrative Review Board (H.B. 48)

� Environmental Tobacco Smoke Elimination and Waiver Act (H.B. 78)

� Vehicle Laws—Distracted Driving and Use of Wireless Communication Devices While Driving—Prohibitions (H.B. 86)

� Health Occupations—Cultural Competency Workgroup (H.B. 100)

� Maryland Comparative Negligence Act (H.B. 110)

� Business and Economic Development—Biotechnology Investment Incentive Act (H.B. 142)

� Maryland Health Care Commission—Chronic Care Management and Wellness Promotion—Study (H.B. 171)

� Maryland Medical Assistance Program—Eligibility Expansion (H.B. 202)

� Workers’ Compensation—Appeals—Admissibility of Medical Records (H.B. 203)

� Higher Education—State Student Financial Assistance—Eligibility (H.B. 283)

� Maryland Fetal and Infant Mortality Review (H.B. 357)

� Income Tax—Tax Credit—Donations for Scholarships at Institutions of Higher Education (H.B. 531)

� Medical Malpractice - Medical Liability Division Task Force (H.B. 779)

� Maryland Medical Assistance Program—Community Choice Program Excluded Populations (H.B. 796)

� Healthy Families and Healthy Workplaces Act (H.B. 832)

� Job Skills Advancement Training Programs (H.B. 926)

� Solar and Geothermal Energy Grant Program (H.B. 960)

� Maryland Nonprofit Development Center Program (H.B. 1014)

� Maryland Rx Program—Modifications (H.B. 1025)

� Health Program—Diabetes—The Maryland P3 Program (H.B. 1169)

� Health Services Cost Review Commission - Repeal of Commission and Study of Alternative Financing of Uncompensated and Undercompensated Care (H.B. 1070)

� Negotiated Prices for Medicare Part D Drugs (H.J. 1)

BILLS INTRODUCED

Health Care Facilities

Health Care Practitioners

Health Insurance

Workers’ Comp

BILLS INTRODUCED

Economic Development

HB1007 �Biotechnology Investment Tax Credits

The bill makes several changes to the existing biotechnology investment tax credit as described below:

1) Imposes Eligibility Standards: To be eligible, an applicant cannot, prior to making an investment in a biotechnology company, own more than 25% of the biotechnology company. An applicant also cannot be a person, officer, director, manager, or general partner of the company. Under current law, “property” investments qualify for the credit. The bill limits qualifying investments to cash, and this cash must be an at-risk investment in exchange for stock or an interest in a qualifying biotechnology company or a qualifying convertible debt instrument issued by a biotechnology company.

2) Alters Maximum Credit Value: No more than $2 million in total credits can be awarded for investments made in any one biotechnology company. The maximum value of the credit for qualifying venture capital firms would increase from $250,000 to $1 million.

3) Allows Insurers to Claim Credit: Insurance companies making qualifying investments are eligible to claim the credit against the insurance premium tax.

4) Alters How the Credit is Claimed: Under current law, the credit is refundable.� The bill eliminates the refundability of the credit beginning with investments made after December 31, 2006. Any unused amount of the credit can be carried forward indefinitely until the full amount of the credit is claimed.

5) Alters Administrative Aspects: Under current law, a venture capital firm can qualify if at least two principals have at least five years venture capital experience.� The bill clarifies that these two principals must have five years of experience managing venture capital investments made with money raised from unaffiliated investors.�

The bill provides that credits are earned and vested when the qualifying investment is made, and provides for the allocation of the credit amongst members of a partnership or limited liability company.

Effective Date:� July 1, 2007

For more information, please contact:� Tom Lewis

HB1197 �Business and Economic Development - Maryland Research and Development Tax Credit

This departmental bill clarifies that Maryland Research and Development Tax Credits would still be available if the federal Research and Development Tax Credit Program is repealed or terminated.

Effective Date:� July 1, 2007

For more information, please contact:� Tom Lewis

HB1320 �Joint Committee on Base Realignment and Closure

This bill creates the Joint Committee on Base Realignment and Closure comprised of six members of the House of Delegates and six members of the Senate. Staffing is to be provided by the Department of Legislative Services.

In order to accelerate planning and development in preparing the State for the influx of jobs and personnel associated with the Base Realignment and Closure initiative of 2005 (BRAC), the committee must develop systems and processes that fast track the approval of the following: transportation infrastructure;� water and sewer infrastructure; State and local planning processes; affordable housing options; and education facilities, including public school and community college construction.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

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Environmental Health

HB1294 �Task Force to Study the Economic Development Benefits of the Clean Energy Industry in Maryland

The task force will analyze and recommend policies, standards, and mechanisms needed to, among other things, promote the development of clean energy industry in the State; increase the demand for clean energy in the State through alternative energy generation and energy efficiency programs; require all public buildings, and facilitate the effort of private buildings, to meet the standard for high performance, “green” buildings; and promote efficient metropolitan growth.

The task force will also consider specified approaches to clean energy incentives; compile and inventory statutory and regulatory efforts made by the State to date to address clean energy issues; consider more effective methods of implementing, enforcing, and marketing existing State efforts to address clean energy issues; and develop goals for the future use of clean energy in the State.

Effective Date:� June 1, 2007

For more information, please contact:� Tom Lewis

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General Business

SB0864 �Voice Over Internet Protocol Service and Internet Protocol-Enabled Service

The bill deregulates Voice Over Internet Protocol Service, removing it from the jurisdiction of the Public Service Commission.� Voice Over Internet Protocol Service is defined as any service which allows users to hold real-time two-way voice communications via internet protocol and uses a broadband connection from the user’s location.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

SB0904 �Consumer Protection - Personal Information Protection Act

When a business is destroying a customer’s records containing the customer’s personal information, the business must take all reasonable steps to destroy or arrange for the destruction of the records in a manner that makes the information unreadable or undecipherable through any means.

A business that compiles, maintains, or makes available personal information of a Maryland resident must implement and maintain reasonable and appropriate security procedures and practices to protect the personal information from unauthorized access, destruction, use, modification, or disclosure.� A business that discloses personal information under a contract with a nonaffiliated third party must require by contract that the third party comply with these requirements.

A business that compiles, maintains, or makes available records that include a Maryland resident’s personal information must notify that individual of a breach of the security of a system if, as a result of the breach, the individual’s personal information:

(1) has been acquired by an unauthorized person; or

(2) is reasonably believed to have been acquired by an unauthorized person. Generally, the notice must be given as soon as practicable after the business discovers or is notified about the breach.

The notification may be delayed:

(1) if a law enforcement agency determines that it will impede a criminal investigation; or

(2) to determine the scope of the breach and restore the system’s integrity.

The notification may be given by written, electronic, telephonic, or substitute notice if specified conditions are met. The notice must include:

(1) to the extent possible, a description of the categories of information, including which elements of personal information, that were, or are reasonably believed to have been, acquired;

(2) contact information for the business making the notification;

(3) specified contact information for the major consumer reporting agencies; and

(4) specified contact and other information relating to the Federal Trade Commission and the Office of the Attorney General.

A business must notify the Office of the Attorney General of the breach within 24 hours after it becomes aware of the breach. A waiver of the bill’s notification requirements is void and unenforceable.� Compliance with the notification requirements does not relieve a business from a duty to comply with any other legal requirements relating to the protection and privacy of personal information.�

Compliance with a federal or State law is deemed compliance with the bill regarding the subject matter of that law if the law provides:

(1) at least the same protections to personal information as the bill; and

(2) disclosure requirements that are at least as thorough as the bill’s.

In addition to the penalties under the Consumer Protection Act, an individual who is affected by a violation may bring a civil action against a violator to recover reasonable attorney’s fees and the greater of $500 per violation or actual damages.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

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General Health Care

Hb1048 �Department of Health and Mental Hygiene - Consolidation and Streamlining Act of 2007

This bill renames the Department of Health and Mental Hygiene (DHMH) as the Department of Health and transfers the Maryland Institute for Emergency Medical Services Systems (MIEMSS) to the Office of Preparedness and Response (OPR) in the department.� The State Emergency Medical Services Board (EMS board) is abolished and its functions transferred to MIEMSS.� The bill also authorizes money in the Maryland Emergency Medical System Operations Fund (MEMSOF) to be used for OPR.

MIEMSS will assume the duties of the repealed EMS board, including developing and adopting an EMS plan; adopting regulations for ambulance service licensing; approving EMS provider training courses; examining and certifying EMS personnel; appointing the Provider Review Panel; taking disciplinary action against EMS personnel; and administering the Automated External Defibrillator Program.

The Secretary of the renamed Department of Health must appoint an Executive Director for MIEMSS.� The statewide Emergency Medical Services Advisory Council will advise and assist MIEMSS.� Members of the advisory council are appointed by the Governor.� The EMS Board Provider Fund is renamed the Institute Provider Fund.� Uncodified language authorizes the Governor, for fiscal 2008, to transfer up to 84.1 fulltime equivalent regular positions and $10.3 million in special funds to OPR.� In order to meet these limits the Governor may only eliminate vacant positions, positions in the job family “Officials and Administrators,” and the Executive Director of MIEMSS.� Any additional special funds budgeted for MIEMMS in fiscal 2008 must revert to MEMSOF.� Additional uncodified language requires the department to conduct a comprehensive review of the department to identify methods to streamline or consolidate duplicative or unnecessary boards, commissions, councils, and committees and catalog the reports required by the General Assembly.� The department must submit a report on its review by December 1, 2007.

Effective Date:� October 1, 2007

For more information, please contact:� Sheila Higdon

SB0987 Maryland HIV/AIDS Reporting Act

This emergency bill repeals Maryland’s code-based HIV reporting system and establishes a name-based HIV reporting system.

Physician Reporting: A physician who has diagnosed a patient with HIV must immediately submit a report to the local health officer that includes the name, age, race, sex, and residence address of the patient.� A physician must also submit such a report within 48 hours of the birth of an infant whose mother has tested positive for HIV.� If the infant does not become HIV positive within 18 months of submission of the report, the Secretary must remove the infant’s name from the HIV registry.

Institutional Reporting: A hospital, nursing home, hospice, correctional medical clinic, inpatient psychiatric facility, or inpatient drug rehabilitation program that has an individual in its care with a diagnosis of HIV or AIDS must immediately submit a report to the local health officer that includes the name, age, race, sex, residence address of the individual, name of the administrative head of the institution, and address of the institution.

Laboratory Reporting: The bill repeals the requirement that HIV be reported by laboratories with unique patient identifying numbers.� The director of a medical laboratory must submit a report to the Secretary within 48 hours when a specimen shows evidence of any CD 4+ count or HIV.� Instead of a unique patient identifying number, the report must state the name, age, sex, and residence address of the patient.� The bill repeals language authorizing the director of a medical laboratory, the Secretary, a health officer, or their agents to compile or distribute a reproducible list of the names of patients that are in reports required to be submitted by laboratories.� The bill also repeals an exception to this authorization for the names of patients in reports relating to HIV and CD 4+ count under 200/MM3.� The bill further repeals language prohibiting the director of a medical laboratory from disclosing the identity of any individual tested for HIV to DHMH or a local health officer.

Penalties: Any person who knowingly and willfully discloses personal identifying health information acquired for the purposes of HIV and AIDS reporting is guilty of a misdemeanor and on conviction is subject to a $1,000 fine for a first offense and a $5,000 fine for each subsequent conviction.� Any person who knowingly and willfully requests or obtains information on HIV and AIDS under false pretenses or through deception on conviction is subject to maximum penalties of five years in prison and/or a $100,000 fine.� If the offense is committed with intent to sell, transfer, or use individually identifiable information for commercial advantage, personal gain, or malicious harm, a violator is subject on conviction to maximum penalties of 10 years in prison and/or a $250,000 fine.� A health care provider who violates these provisions is liable for actual damages.� A physician, laboratory, or institution that in good faith submits a report or discloses information in accordance with the bill is not liable in any action arising from the disclosure of the information.

All institutional HIV and AIDS reports, HIV reports from physicians, and laboratory reports submitted relating to HIV and AIDS are not medical records and are confidential, not discoverable, and not admissible in evidence in any civil action.� A custodian shall deny inspection of the part of a public record that contains any report on HIV or AIDS submitted in accordance with the bill.

Effective Date:� Emergency Measure

For more information, please contact:� Jessica Best

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Health Care Facilities

SB0911 �Higher Education - University of Maryland Medical System - Subject to State Access to Public Records Law

The bill makes the University of Maryland Medical System subject to provisions of state law relating to access to public records.

Effective Date:� October 1, 2007

For more information, please contact:� Sheila Higdon

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Health Care Practitioners

HB1230 �Physicians - Cosmetic Medical Procedures and Treatments - Regulation

This bill requires a physician to conduct an “on-site evaluation” of an individual before performing a cosmetic medical procedure or treatment.� The procedure or treatment must be performed at the physician’s legal place of business or a hospital or ambulatory surgery center at which the physician is authorized to practice.� A physician may only delegate these procedures or treatments to a licensed physician assistant or a registered nurse who has the appropriate training or certification.� A physician who delegates a procedure or treatment that uses a specified laser or intense pulse light device must conduct an on-site evaluation of the individual at least after every other procedure or treatment.� A delegating physician must be available to immediately treat any complications that arise.

Effective Date:� October 1, 2007

For more information, please contact:� Sheila Higdon

HB1361 �Health Care and Personal Care Services - Abusive Employee Database

The bill establishes the Abusive Health Care Employee Database, in the Department of Health and Mental Hygiene (DHMH).� The database will include those employees who have been found by an employer to be abusive, neglectful or harmful to an individual receiving health care service.� The bill authorizes the Secretary of Health to adopt regulations to ensure the efficient operation of the database.

The bill not does not require employers to submit the names of abusive employees, but should a submission be made, it shall include the following:

� name and identifying information of the employee;

� description of the employee's job;

� charges against the employee along with a copy of the incident report and all supporting documents;

� notice of any formal criminal charges or civil complaints concerning the abuse; or

� neglect length of the employee's employment.

DHMH is charged with verifying the accuracy of the information received and with setting the procedures for implementation of the database.

Effective Date:� October 1, 2007

For more information, please contact:� Sheila Higdon

SB0968 �Quality and Stability in the Personal Care Workforce Act

This bill authorizes independent care providers in the State Waiver for Older Adults Program or the State Medical Assistance Personal Care Program to form, join, or assist a labor organization for the purpose of collective bargaining through an exclusive representative.� The bill:

outlines the process for the independent care providers to elect an exclusive representative, the costs of which have to be paid by the labor organization – prior to an election, at least 30% of independent providers have to sign a card indicating they want representation;
requires certain terms be included in the collective bargaining process including rate of reimbursement, payment and referral methods, benefits, training, equipment and supplies, and other matters to improve the recruitment and retention of independent providers and the quality of care they provide;
specifies that the collective bargaining agreement must include items agreed upon, a binding arbitration procedure, a grievance process, a mechanism for the collection of union dues and union representation fees, and the creation of a labor management consumer committee;
mandates that negotiations have to conclude before January 1 for any item requiring funding for the fiscal year beginning on the following July 1; and
stipulates that, if the first written collective bargaining agreement is not entered into by October 25, 2007, the parties must submit the dispute to binding arbitration.

Beginning in fiscal 2009, the Governor is required to include a general fund appropriation adequate to cover costs resulting from the negotiations authorized under the bill in each annual budget submitted to the General Assembly.

The bill does not grant the independent providers status as State employees, nor does it deny program recipients from participating in the decision-making process regarding their care.

Effective Date:� June 1, 2007

For more information, please contact:� Nicole Xander

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Health Insurance

hb1052 �Health Insurance - Young Adult Coverage Expansion Act

The bill expands eligibility to individuals between 19 and 29 years of age (inclusive) who have a family income at or below 400% of federal poverty guidelines (FPG). Individuals eligible under the bill must pay an annual family contribution to buy into the Maryland Children's Health Program (MCHP) at cost, to be determined by the Department of Health and Mental Hygiene (DHMH).

The bill requires each health benefit plan to allow a child to remain on a parent’s health benefit plan beyond the limiting age of the plan. To remain on the plan, a child must have had continuous coverage for at least two years immediately prior to reaching the limiting age. A child is permitted to remain on the policy until the earlier of the date on which:

the end of the month in which the child turns 25;
the child accepts coverage under another health benefit plan;
the child becomes eligible for employer-sponsored coverage other than as a dependent child;
a parent elects to terminate coverage for the child; or
a parent terminates coverage.

Effective Date:� July 1, 2007

For more information, please contact:� Tom Lewis

Hb1057 �Health Insurance - Equity in Family Coverage

The bill requires that the benefits and eligibility guidelines that apply to any covered dependent be extended to:

(1) an adult member of the household who is not a child of, and who resides with, the insured, subscriber, employee, or member; and

(2) a child member of the household who is not the legal dependent of, and who resides with, the insured, subscriber, employee, or member, provided the child has not attained the limiting age under the terms of the policy or contract.

An insurer or nonprofit health service plan may require proof that the adult or child member of the household resides with the insured, subscriber, employee, or member, but must pay the cost of the proof.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

hb1059 �Family Health Care Affordability Act

This bill creates a tax credit against the State income tax for eligible health care costs incurred by an individual with federal adjusted gross income (FAGI) of 400% or less of federal poverty guidelines (FPG). The credit is equal to the amount by which an individual’s health insurance premiums, deductibles, co-payments, and coinsurance payments exceed 5% of the individual’s FAGI, subject to a maximum of $1,000 for an individual and $2,000 for a joint return and individual with dependent(s). If the amount of the credit exceeds the tax liability in the year, a taxpayer can claim a refund in the amount of the excess. The bill provides that taxpayers who itemize must reduce the amount of itemized deductions by the lesser of the amount deducted under the federal medical and dental expenses deduction or the amount of credits claimed under the provisions of this bill.

Effective Date:� July 1, 2007

For more information, please contact:� Tom Lewis

HB1238 �Health Coverage Appeals Fairness Act

This bill permits a Medicaid or Maryland Children’s Health Program (MCHP) applicant or recipient aggrieved by a final decision of the Secretary of the Department of Health and Mental Hygiene concerning program eligibility or for a benefit or service under the program to seek direct judicial review.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

HB1283 �Maryland Health Insurance Plan - Authority

This departmental bill authorizes the Maryland Health Insurance Plan (MHIP) to offer members an optional endorsement to remove a preexisting condition limitation, if such a limitation is implemented. MHIP may charge an actuarially justified additional premium amount for the endorsement, subject to approval by the Maryland Insurance Commissioner. The bill also permits MHIP to charge different premiums based on the cost-sharing arrangement when more than one cost-sharing arrangement is offered.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

HB1374 �Health Insurance - Health Reimbursement Accounts and Health Savings Accounts - Current Deductible and Account Balance Information

This bill requires insurers, nonprofit health service plans, HMOs, dental plan organizations, and third-party administrators (carriers) that offer health reimbursement accounts (HRAs) or health savings accounts (HSAs) to establish a method to provide current deductible information directly to health care providers and enrollees participating in HRAs or HSAs offered by the carrier.

The method must: be automated; provide real time deductible and account balance information at the time a health care service is provided; provide the deductible and account information promptly to the provider or enrollee; and allow providers to access deductible and account information on a reasonable number of enrollees at the same time.� A carrier must provide current deductible and account information on request of a provider or enrollee.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

HB1425 �Insurance Producers - Use of Trade Name

This departmental bill prohibits a licensed insurance producer from using any name other than the name in which the license is issued or a trade name filed with the Maryland Insurance Commissioner to engage in any activity for which a license is required. The bill also requires licensees to file name changes with the Commissioner. According to the bill, a trade name means a name, symbol, word, or combination thereof that a person uses to identify its business, occupation, or self in a business capacity and to distinguish itself from another business, occupation, or person.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

SB0749 �Health Insurance - Provider Contracts - Conditions of Participation with Carriers

The bill repeals provisions prohibiting a carrier that offers coverage through a health benefit plan from requiring a provider, as a condition of participation or continuation on a provider panel for one of the carrier’s health benefit plans, to also serve on a provider panel for another of the carrier’s health benefit plans. The bill also repeals the exception that allows a carrier that offers health services as a Medicaid MCO to require a provider, as a condition of participation on a provider panel for one or more of the carrier’s health benefit plans, to serve on an MCO provider panel as well.

The bill provides instead that a provider contract may not contain a provision that requires a provider, as a condition of participation with a carrier, to participate with a different carrier. The prohibition does not apply to:

(1) a carrier that offers health care services as an MCO, which may require that a provider participate in multiple provider panels; or

(2) a provider contract that does not provide different rates or reimbursement for services, require different administrative procedures, or require different procedures to the adjudication of claims for health care services provided to enrollees covered by different carriers.

A “provider contract” is a contract between the provider and a carrier, a carrier affiliate, or an entity that contracts with a provider to serve a carrier. A carrier is responsible for a violation of any provision of the bill, regardless of whether the carrier has subcontracted with an affiliate or entity that contracts with a provider.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

SB0933 �Health Insurance - Public Health Plans - Education and Disclosure Requirements

This bill requires licensed insurance producers to provide small employers with information about public health plans available in Maryland (including the Maryland Children’s Health Program (MCHP) and Medicaid) at the time the small employer enrolls in a health benefit plan. As a condition of coverage, a small employer must agree to provide information about Maryland public health plans to eligible employees who elect not to be covered and have no other health insurance coverage.� The bill further specifies that the program of studies required for insurance producers must include a course on public health plans, the insurance producer licensing examination must determine an applicant’s familiarity with public health plans, and licensed insurance producers must receive continuing education that relates to public health plans.

Effective Date:� October 1, 2007

For more information, please contact:� Tom Lewis

SB0944 �Health Insurance - Habilitative Services - Covered Persons

This bill requires insurers, nonprofit health service plans, and health maintenance

organizations (carriers) to provide coverage of habilitative services for all covered

persons regardless of age.� Currently, carriers must cover habilitative services for

children under the age of 19 and may do so through a managed care system and carriers are not required to provide reimbursement for habilitative services delivered through early intervention or school services.

Effective Date:� July 1, 2007

For more information, please contact:� Tom Lewis

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Workers’ Comp

SB0929 �Workers' Compensation Insurance - Subrogation Rights of Insurers

This bill provides that if an insurer makes payment for a claim under the Workers’ Compensation Act, the insurer is subrogated to the cause of action of the claimant receiving the payment against the Maryland Automobile Insurance Fund or uninsured motorist coverage under a motor vehicle liability insurance policy.

Effective Date:� October 1, 2007

For more information, please contact:� Nicole Xander

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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
47 State Circle, Suite 203
Annapolis, MD 21401
410-269-0057
fax 410-269-1574

State
Jessica Best� �� [email protected]

Mickey Geisler�� [email protected]

Matthew Greenwood�� [email protected]

Sheila Higdon�� [email protected]

Tom Lewis�� [email protected]

Nicole Xander�� [email protected]

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Office of Government, Community and Public Affairs.