2009 SESSION OF THE
MARYLAND GENERAL ASSEMBLY
Volume
16, Number 8����������������������������������������������������� ������������� ����������������������������������� June
2009
The
Maryland General Assembly adjourned sine
die at midnight on April 13th.�
This session followed a year during which ongoing revenue write downs
necessitated repeated cuts to the current operating budget.� In response to the economic outlook, the
overall FY 2010 General Fund budget, as introduced in January, shrank in
comparison to the prior fiscal year, which is an unprecedented distinction in
Maryland’s budget history.� In
March the State Board of Revenue Estimates again wrote down their estimate of
state income, signaling the need for further cuts to the budget.� This resulted in combined total write downs
of about $3.16 billion for the FY 2009 and FY 2010 budgets. �An approximate $4 billion influx of Federal
stimulus funding in mid-March was instrumental in balancing the FY 2009 and FY 2010
budgets.� Although the difficult fiscal
situation was a source of friction throughout the session, Johns Hopkins’
interests fared very well in light of these challenges.
To
view the legislative information below, click on the subject of interest to go
directly to that area or scroll down to view the entire document.� Background and summary information is
provided for each subject area followed by details on the bills that passed of
interest to Johns Hopkins.� All of these
bills have been signed into law by Governor O’Malley.
PASSED BILLS
STAFF CONTACT INFORMATION
EMPLOYMENT/LABOR/WORKER’S
COMPENSATION
HEALTH
CARE FACILITIES/HEALTH CARE ADMINISTRATION
HEALTH
INSURANCE/HEALTH CARE ACCESS
HEALTH - GENERAL/PUBLIC/ENVIRONMENTAL
HIGHER
EDUCATION/FINANCIAL AID
The
legislature adopted a capital budget
program of $3.5 billion (with $1.1 billion in newly authorized general
obligation bonds), including the Governor’s proposed FY 2010
appropriation of $10 million for the Pediatric Trauma Center (PTC) and $7
million for the Cardiovascular and Critical Care Tower (CCCT), for a total of
$17 million for the Johns Hopkins
Hospital’s New Clinical Buildings. The Governor’s FY 2010
five-year proposed state Capital Improvement Plan (CIP) includes an additional
13 million over the next two fiscal years, and brings the total amount of state
support to $100 million for this project, the full amount� requested by Johns Hopkins.� The table below shows the schedule for
remaining allocations for each building.
|
Project |
Prior
Authorization |
FY2010 |
FY2011 |
FY2012 |
TOTAL |
|
PTC |
35M |
10M |
5M |
|
50M |
|
CCCT |
35M |
7M |
2.5M |
5.5M |
50M |
The
General Assembly has also adopted the Governor’s proposed $250,000 in FY
2010 for Howard County General Hospital’s request through the Maryland Hospital Association’s
private hospital grant program. The request is specifically for
construction of the $1.1 million Progressive Care Unit.
Other
hospitals slated to receive funding through this $5 million grant program
include the following:
|
Kennedy
Krieger |
$600,000 |
Neurobehavioral
Unit and Pediatric Feeding Disorder Unit |
|
Sinai |
$260,000 |
Post-Anesthesia
Care Unit Expansion |
|
Calvert
Memorial |
$800,000 |
Infusion
Therapy Center Renovation/Expansion |
|
Civista |
$� 90,000 |
Dialysis
Center Relocation/Expansion |
|
Upper
Chesapeake |
$600,000 |
Residential
Hospice Construction |
|
Chester
River |
$330,000 |
Pharmacy
Renovation/Expansion |
|
St.
Mary’s������ |
$1,800,000 |
Medical/Surgical
Unit Relocation |
|
Atlantic
General |
$270,000 |
Pharmacy
Relocation/Expansion |
�����������������������������������
Other capital
projects of interest
-
Sinai
received an additional $2.5 million appropriation for a new pediatric wing for
their inpatient and outpatient services; their original request for $5 million
is authorized over a two year period.
-
The
de-authorization of a $1 million grant to Bon Secours was approved.� First authorized in 2007, the grant was intended
for an intensive care unit project that is no longer being pursued. The
funds were re-purposed, and $770,000 (instead of the initially granted $1
million) was authorized to fund a locked unit for use by the Division of
Correction at Bon Secours and increased the holding capacity for patients from
the Division of Correction.
-
The
University of Maryland Medical System has deferred capital funding for its
proposed New Ambulatory Care Center in lieu of funding for additional inpatient
beds for Shock Trauma. The capital budget includes $15 million for Shock
Trauma renovation and expansion.
-
The
Governor’s capital budget also includes $5 million for East Baltimore
Development, Inc. (EBDI) in FY 2010, and the CIP includes $5 million in each of
the next four fiscal years. These appropriations, coupled with $21
million in prior authorizations, total $46 million in State capital funding for
this initiative.
-
In
addition, the capital budget includes $9 million for the three MICUA capital
projects: $3.5 million for the College of Notre Dame of Maryland, $3
million for Baltimore International College, and $2.5 million for Capitol
College. This appropriation is $1 million above the Governor’s
allowance, and equal to the $9 million appropriation from last year.
-
Finally,
the capital budget included $5.6 million to allow for planning and design for
the New Public Health Laboratory for FY 2010, to be located in EBDI.� The Department of Health and Mental Hygiene
(DHMH) is pursuing a public-private partnership with EBDI to finance the
project.� The General Assembly included
language which would provide greater legislative oversight of the project, and
give the Board of Public Works the power to review the final partnership
agreement.
-
�After considerable debate on the trauma system,
the General Assembly approved $52.5 million to replace three medevac
helicopters in the coming year.
The
General Assembly approved a $32.3 billion operating budget (about $14 billion
in general funds), which included $897 million in spending reductions.� Some areas of the operating budget affecting
Johns Hopkins include:
Total
funding for the Sellinger Aid Program
was increased from the Governor’s appropriation of $50.6 million in FY
2010 to $52.177 million for FY 2010. This is an increase of 3.4% over the
FY 2009 appropriation and the Governor’s proposed FY 2010
appropriation. Johns Hopkins’ funding will increase from $21
million to $22 million, a 5.1% increase.�
The final budget included the so-called “True Up” provision,
agreeing that future Sellinger Program appropriations will be based on the
state’s current-year appropriation to Maryland’s public
universities rather than the prior-year appropriation. The “True
Up” will allow independent colleges and universities to participate
immediately in any increases in state support for higher education rather than
having a year delay as in past years.�
The final budget also adjusts the Sellinger multiplier upward in FY 2011
- FY 2014 to restore the program to full funding by 2014.
Both
Johns Hopkins Cigarette Restitution Fund
(CRF) grants are level funded at the FY 2009 appropriation, reflecting the
reductions to the research grant taken by the Board of Public Works, resulting
in funding of $1.6 million for the Cancer Research Grant and $1.2 million for
the Public Health Grant.
Because
of the state’s dire fiscal picture, and the fact that President Obama
reversed the executive order prohibiting the use of federal funds for embryonic
stem cell research, support for the State’s Stem Cell Research Fund program was in jeopardy. However, the
Governor proposed $18.4 million, and despite the $1.1 billion write down of
expected revenues in March the General Assembly approved $15.4 million in state
funding.
The
final budget fully funded the Governor’s appropriation of $6 million for
the Biotechnology Tax Credit Program,
level funding it at the FY 2009 level.
The
Coordinating Emerging Nanobiotechnology
Research in Maryland Program (CENTR) grants were not funded in the FY 2010
Budget.
After
much discussion the House and Senate decided against making any reductions to
the HealthChoice program.� The budget does include language which
requires the Secretary of the Department of Health and Mental Hygiene (DHMH) to
direct the Maryland Insurance Administration to initiate a market conduct and
financial study of all managed care organizations in the next two calendar
years, and requires an interim report on these studies by December 1, 2009, and
a final report on the studies by December 1, 2010.
The
first phase of the Medicaid expansion
plan, which includes the parents of children enrolled in MCHIP up to 116% of
the federal poverty level (FPL) will be maintained. However, the
State’s fiscal challenges have necessitated the postponement of the
second phase, which would have extended health care coverage for childless
adults up to 116% of the FPL through expansion of the existing Primary Care
Adult program.
$22
million of the Department of Health’s FY 2010 budget was contingent upon
passage of False Health Claims legislation (details of which are reported in
the Health Care Facilities/Health Care Administration sections of this
report).� Since that legislation failed,
the Governor introduced a supplemental
bill in the final days of the session that imposes a $20 million cut to
hospitals in the form of Medicaid day limits ($10 million in general funds, and
a matching amount in federal funds), and a total of $9.5 million in a reduction
for Medicaid physician reimbursement rates.
Additional Budget
Actions
-
Expanded
purposes for use of funds generated from the hospital assessment; approved uses
now include Medicaid payments to hospitals and general operations of the
Medicaid program.
-
Transferred
various special funds to the general fund, including $17 million from the
Maryland Physicians Trauma Fund, $51.5 million from the State Police Helicopter
Replacement Fund, $3 million from the Board of Physicians Fund, $2 million from
the Maryland Health Care Commission Fund, $500,000 from the Board of Nurses
Fund, and $14 million from the Community Health Resources Commission.
-
Withheld
$10 million from the DHMH budget pending submission of a report on the proposed
closing of the Walter P. Carter Mental Health Center.
-
Approved
an operating grant of $5 million for Bon Secours Hospital, with funds being
withheld until Bon Secours provides a report to DHMH and the budget committees
detailing a long-term, comprehensive, and sustainable solution to the
hospital’s financial issues. The report must include a plan for
implementing by FY 2011 a sustainable primary-care centric approach that
includes urgent care and primary care access; improved mental health services;
additional substance abuse assessment and treatment services; and other
critical community services. The budget committees will have 45 days for
review and comment.
-
Appropriated
$235,000 in subsidies for medical professional liability insurance to family
practitioners with staff privileges providing obstetrical services at Garrett
County Memorial Hospital.
No
major economic development initiatives were passed this session due to the State’s
fiscal situation.� However, a significant
modification to the Biotechnology Tax
Credit Program, which was supported by Johns Hopkins, did pass and will
strengthen the existing program.� The Coordinating Emerging Nanobiotechnology
Research in Maryland (CENTR) program was not funded this year.
Please
find details on relevant bills which passed below.
HB0438 �Joint Information Technology and Biotechnology
Committee - Membership and Duties
HB 438 renames the Joint Technology Oversight
Committee as the Joint� Information
Technology and Biotechnology Committee.�
It also expands the Committee's scope to include work to broaden
support, knowledge, and awareness for information technology and
biotechnology.� The Committee will
consist of 6 members from the Senate and 6 members from the House of Delegates
as appointed by the presiding officers; and, will issue an annual report to the
legislature each December.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#140
For more information, please contact:�
Mat Palmer
HB0493 �Biotechnology Investment Incentive Tax Credit
HB 493 alters the definitition of a
"qualified investor" under the Biotechnology Investment Incentive Tax
Credit to include "an individual."�
It also clarifies that the tax credit must be claimed for the taxable
year in which the investent was made, and clarifies under what circumstances
the credit can be reclaimed by the State.
Effective Date:� July 1, 2009
Signed by the Governor on 5/29/3009; Chapter #606
For more information, please contact:�
Mat Palmer
HB1124 �Coordinating Emerging Nanobiotechnology Research in
Maryland Program - Public Private Partnerships
HB 1124 requires TEDCo, through the Coordinating
Emerging Nanobiotechnology Research in Maryland Program, to foster
public-private partnerships as feasible.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#160
For more information, please contact:�
Mat Palmer
EMPLOYMENT/LABOR/WORKER’S
COMPENSATION
This
session saw the introduction of over 150 employment and labor bills; most aimed
at expanding the rights and protections of Maryland employees.�
Last
session, broad legislation granting “Flexible
Leave” to Maryland employees was passed.� The legislation allowed employees to take
unrestricted leave to care for ill family members.� Many Maryland employers were concerned about
the possibility of abuse of the Flexible Leave Act because there were no
provisions for employers to verify leave.��
Johns Hopkins worked with the sponsor of the bill from last session, the
Maryland Chamber of Commerce and other Maryland employers to draft clarifying
legislation that was passed this session.�
The new law will provide specific definitions for key terms, require
that the same requirements for personal leave apply to leave taken for an ill
family member, and clarify the anti-retaliation provisions.� Bills that would have allowed Maryland
employees to use leave to attend parent teacher conferences and care for
immediate family members including domestic partners failed.��
After
President Obama signed the federal Lilly
Ledbetter Fair Pay Act into law earlier this year, lawmakers passed
comparable legislation in Maryland.� The
Lilly Ledbetter Civil Rights Act of 2009 will give an employee up to six months
from the date of the last discriminatory paycheck to file a pay discrimination
claim.� Each discriminatory pay check
renews the six month limit to file a claim.��
Previously, Maryland employees had up to six months from the date of the
original occurrence of the alleged discriminatory act to file a complaint.�
The
definition of disability in employment
discrimination law was expanded with the passage of House Bill 393, Discrimination
in Employment - Expansion of Disability Rights but proposed legislation that
would have expanded discrimination protections to include an individual’s
gender identity or sexual orientation failed.�
Two
competing, and unsuccessful, joint resolutions were introduced urging �the President and the United States Congress
to either support or oppose legislation to eliminate the private election phase
of union recognition campaigns. The Employee Free Choice Act, would have urged
the United States Congress to enact legislation to eliminate the union secret
ballot election system and replace it with a public certification process and
"Card Check."� The other resolution on this subject would
have declared the State’s opposition to federal proposals that would
eliminate the worker’s right to privately decide whether or not to allow
a particular union to represent their interests.� Both joint resolutions were withdrawn.
Bills
that would have required Maryland employers to grant employees a 15 minute shift break for every 4 hours worked or
a 30 minute break for every 4 to 6 hours worked in addition to a lunch break
failed.� The bill presented an issue for
health care facilities as it did not provide an exemption for employees who
could not safely be relieved for additional shift breaks if their absence could
adversely affect the quality of care for patients.
A
bill that would have changed current law to require that employers pay overtime worked in excess of 8
hours a day as opposed to 40 hours per week was strongly opposed and defeated
by the business community.
Please
find details on these and other relevant bills which passed below.
HB0162 �Insurance - Notice of Premium Increase for Commercial
and Workers' Compensation Insurance
HB 162 requires commercial and workers
compensation insurers to provide notice for all premium increases.� Notice is not required if the increase is the
result of an increase in the units of exposure; the application of an
experience rating plan; the application of a retrospective rating plan; a
change made by the insured that increases exposure; or an audit of the
insured.� An insurer has met the notice
requirement if not less than 45 days before the effective date of the insurance
policy the insurer has sent a renewal policy with the renewal policy premium,
written notice of renewal or continuation of coverage, or a renewal offer.
Effective Date:� January 1, 2010
Signed by the Governor on 5/7/2009; Chapter #376
For more information, please contact:�
Delora Sanchez
HB0242 �Unemployment Insurance Benefits - Determination Based
on Severance or Dismissal Payments
HB 242 makes the determination of unemployment
insurance benefits for individuals who receive or are eligible to receive
severance or dismissal payments the same whether or not their unemployment is
due to the abolishment of their job.��
Depending on the amount of payments an individual receives; the
individual may be disqualified from receiving certain benefits or may receive
reduced benefits.
Effective Date:� June 1, 2009
Signed by the Governor on 5/7/2009; Chapter #383
For more information, please contact:�
Delora Sanchez
SB0084 �Health Insurance - Medicare Coverage and Continuation
Coverage - Provisions That Relate to Federal Laws and Programs
SB 84 requires a carrier to make a Medicare
supplement policy plan A available to an individual who is under 65 but
eligible for Medicare due to a disability; the rate charged must not be a
higher rate than the average premium amount for all policy holders in the state
that are over 65 years of age.� Under the
law, �individuals who have been laid off
from small firms have a second opportunity to continue coverage of their health
benefits and receive a federal subsidy of their premium.� The minimum requirements for Medicare supplement
policies will be changed to correspond with the minimum benefits required under
federal law.
Effective Date:� Emergency Measure
Signed by the Governor on 4/14/2009; Chapter #22
For more information, please contact:�
Delora Sanchez
SB0270/HB0310
�Unemployment Insurance - Eligibility - Part-Time Work
SB 270/HB0310 authorizes an individual who is
only available to work part time (15 hours per week) to be eligible for
unemployment benefits.� In order to
qualify for unemployment benefits, the individual must predominately work part
time throughout the year.
Effective Date:� Emergency Measure
Signed by the Governor on 4/14/2009; Chapter #6
& 7
For more information, please contact:�
Delora Sanchez
SB0368/HB0288� Lilly Ledbetter Civil Rights Restoration Act of 2009
SB 368/HB 288 clarifies that discrimination in
compensation occurs when: a discriminatory compensation practice or decision is
adopted; an individual becomes subject to a discriminatory compensation
practice or decision; or an individual is affected by the application of a
discriminatory compensation decision or practice. Liability may accrue,
including recovery of back pay, for up to 2 years before filing the complaint,
effectively expanding the time period that an employee may seek relief for an
unlawful employment practice.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #56
& 57
For more information, please contact:�
Delora Sanchez
SB0670/HB0393
�Discrimination in Employment - Expansion of Disability
Rights
SB 670/HB 393 expands the definition of
disability in employment discrimination law to include individuals who have a
record of, or are regarded as, having a physical or mental disability.� An employer is prohibited from refusing to
make reasonable accommodations for an employee’s disability unless the
accommodation would cause undue hardship.�
An employer or labor union is prohibited from retaliating against an
employee for opposing, reporting, or challenging a discriminatory practice in
an investigation, proceeding, or hearing.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #299
& 300
For more information, please contact:�
Delora Sanchez
SB0863/HB0899
�Workers' Compensation - Death Benefits for Partially
Dependent Individuals - Payment
SB 863/HB 899 increases the maximum amount of
death benefit payment to an individual who was partially dependent at the time
of the covered employee’s death from $60,000 to $75,000.� The Workers Compensation Commission is
required to conduct a study to determine legislative changes to ensure that
benefits to dependent and partially dependent individuals are fair, equitable,
and properly coordinated.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #616
& 617
For more information, please contact:�
Delora Sanchez
SB0909 �Workplace Fraud Act of 2009
SB 909 (an administration bill requested by the
Governor) imposes penalties on employers for knowingly misclassifying an
employee as an independent contractor for the purpose of avoiding payroll
taxes.� The bill only applies to the
construction and landscaping industries and does not apply to sole proprietors (who
meet certain criteria) or owner operators.�
Employers must give written notice to workers when they are being paid
as an independent contractor or sole proprietor.� A civil penalty of up to $5,000 may be
assessed for each misclassified employee; other penalties also apply.� The Commissioner of Labor and Industry is
authorized to investigate a violation on their own initiative; receipt of a
complaint; or referral from another unit of state government.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #188
For more information, please contact:�
Delora Sanchez
Plans
to re-regulate Maryland’s
electricity markets ultimately stalled this session.� One bill which would have re-regulated the
residential and small commercial markets passed the Senate but was defeated in
the House Economic Matters Committee.
Of
the many bills introduced to address minority
business enterprise (MBE) participation in state-funded projects, one bill
impacting hospitals and institutions of higher education failed on the final
day of the session.� As amended, it was
strongly supported by the Administration and its provisions were consistent
with the initiatives that MHA and MICUA institutions already have in place. �The legislation would have required grantees
to report on the extent to which they have used, or will use, any part of the
state funds received for contracts with minority-owned businesses for the
purchase of goods, services, construction, or construction services. �The sponsors of the bill indicated their intent
to use this as an opportunity to encourage other business entities to follow
the examples of hospitals and institutions of higher education to voluntarily
increase the participation of minority businesses in their contracting for
goods, construction, and other services.
Two
pieces of legislation did pass that address issues related to MBE owners whose
personal net worth exceeds the amount specified in current statute, thus
rendering their companies ineligible for state MBE certification.� One bill requires the cap on personal net
worth to be adjusted annually in accordance with the Consumer Price Index, and
excludes up to $500,000 of the cash value of any qualified retirement savings
plan or IRA from being considered in the calculations of personal net
worth.� The bill also requires the
Maryland Department of Transportation (MDOT) to study whether the personal net
worth cap should be further adjusted and report its findings to the General
Assembly in December 2010.� Another bill
requires MDOT to include in the existing MBE directory those businesses which
have become ineligible to participate in the MBE program because one or more of
the owner’s personal net worth exceeds the cap (or does not meet one of
the other standards required for participation).
Please
find details on relevant bills which passed below.
HB1297 �Procurement - Minority Business Enterprises - Prime
Contractors
HB 1297 requires the Board of Public Works (BPW)
to include in its regulations for the minority business enterprise (MBE) program
provisions that promote and provide for the counting and reporting of MBEs as
prime contractors. The bill also adjusts annual MBE reporting requirements to
reflect these changes.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #715
For more information, please contact:�
Sheila Higdon
SB0072� Higher Education - Institutions of Postsecondary
Education - Exempt Institutions
SB 72 prohibits an institution of postsecondary
education which operates without an MHEC certificate of approval from making
reference to, or representation of, the approval or exemption by MHEC on any
certificates, diplomas, academic transcripts, advertisements, or publications.
The bill also imposes a fine of up to $5,000 for each violation.
Effective Date:� October 1, 2009
Vetoed by the Governor on 5/19/2009
For more information, please contact:�
Mat Palmer
SB0489/HB0471
�Minority Business Enterprise Certification - Cap on
Personal Net Worth
SB 489/HB 471 requires that the personal net
worth cap for eligibility in the State’s Minority Business Enterprise
(MBE) program be adjusted annually according to the Consumer Price Index (CPI).
Personal net worth does not include up to $500,000 of the cash value of any
qualified retirement savings plan or individual retirement account.
The Maryland Department of Transportation (MDOT), in consultation with the
Attorney General’s Office and specified legislative committees, must
evaluate whether the personal net worth cap should be further adjusted, and report
its findings to the General Assembly by December 1, 2010.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #267
& 268
For more information, please contact:�
Sheila Higdon
SB0211/HB0641
�Minority Business Enterprise Program - Participation
by Race or Gender
SB 211/HB 641 allows a woman-owned business that
is owned by a member of a racial or ethnic minority group to be certified as
both a woman-owned business and as a business owned by a member of a recognized
racial or ethnic minority group under the State’s minority business
enterprise (MBE) program.� It also allows
firms with dual certification to participate in an individual procurement
contract as either a woman-owned business or as a business owned by a member of
a racial or ethnic minority group, but not both.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #222
& 223
For more information, please contact:�
Sheila Higdon
SB0611/HB0389
�Minority Business Enterprise Program - Prohibitions
and Penalties for Contractors
SB 611/HB0389 prohibits a contractor from
including a certified MBE in a bid or proposal
without requesting, receiving, or obtaining the MBE’s authorization
to identify the MBE in the proposal or bid; notifying the MBE of its inclusion;
and actually using the MBE’s services to perform the contract. In
addition, the contractor may not pay the MBE solely for the use of its name in
the bid or proposal.
The bill also requires the Governor's Office on Minority Affaris to operate
a fraud hotline that may be used to report violations.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #292
& 293
For more information, please contact:�
Sheila Higdon
Legislation
directing DHMH to report to the General Assembly on the feasibility of creating
a coordinated care program to reform the
provision of long-term care services under the Medical Assistance program
passed.�� As originally drafted, the bill
would have required DHMH to immediately resume efforts to obtain a waiver from
the Centers for Medicare and Medicaid Services (CMS) for a managed care program
for the dually eligible population.�
However, DHMH and other stakeholders worked to significantly amend the
bill such that a waiver will be sought only if DHMH – after input from
all parties – deems it the best alternative to implement a program that
improves and integrates care of individuals in a manner that meets the differing
needs of seniors and adults with disabilities in the state.� An interim report is due in September 2009,
and a final report in December 2010.� If
the consensus recommendations in the final report include the resubmission of a
waiver, that action must be taken by June 1, 2011.
A
bill that would have permitted nursing
home residents to install video cameras in their rooms, at their own
expense to monitor their care, failed again this year.� However, the Office of Health Care Quality
has been asked by the House Health and Government Operations Committee to
institute a pilot program in one or more nursing homes in order to determine
the feasibility of the use of video cameras in nursing homes to monitor the
care of the residents.�
Please
find details on relevant bills which passed below.
HB0113 �Department of Health and Mental Hygiene - Long-Term
Care Supports and Services - Report
HB 113 requires the Secretary of Health and
Mental Hygiene to convene a group of stakeholders to review and make recommendations
reforming the provision of long-term care services under the Medicaid program
and other state programs.� The workgroup
is directed to issue an interim report of its findings and recommendations by
December 1, 2009, and issue a final report the following December.� Specifically, the workgroup will consider the
feasibility of creating a coordinated long-term care program within the
state-funded programs and draft any recommended legislation including, if
deemed appropriate, a timeframe for submitting a federal waiver to implement a
long-term care program.
Effective Date:� July 1, 2009
Signed by the Governor on 5/7/2009; Chapter #371
For more information, please contact:�
Sheila Higdon
HB1480 �Interagency Committee on Aging Services - Membership
HB 1480 adds the Secretary of Veterans Affairs
(VA), the Director of the Governor’s Office of the Deaf and Hard of
Hearing, and the Chair of the Commission on Aging to the membership of the
Interagency Committee on Aging Services.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #737
For more information, please contact:�
Sheila Higdon
SB0471 �State Board of Examiners of Nursing Home
Administrators - Composition & Executive Director
SB 471 expands the membership of the State Board
of Examiners of Nursing Home Administrators from 11 to 13 members.� Additional members include: a licensed
nursing home administrator experienced with the Eden Alternative Green House or
a similar program, if practicable; a physician or a nurse practitioner who
specializes in geriatrics; a geriatric social worker; and a representative of
the Office of Health Care Quality who serves as an ex officio member.� The number of consumer members is reduced
from four to two, and one of the consumer members must have, or have had, a
family member living in a nursing home.�
The bill requires the full board to appoint, and the Secretary of Health
and Mental Hygiene to confirm, the executive director, who must have at least a
bachelor’s degree. That requirement does not apply to the current
executive director.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #71
For more information, please contact:�
Sheila Higdon
SB0664/HB0782
�Nursing Facilities - Accountability Measures -
Pay-for-Performance Program
SB 664/HB 792 requires the Department of Health
and Mental Hygiene (DHMH), to phase in the distribution of revenues to nursing
facilities under the pay-for-performance (P4P) program for nursing
facilities.� Implementation will begin
July 1, 2010, with full implementation by July 1, 2011.
By July 1, 2009, DHMH must score each nursing facility based on the
criteria in the December 2008 plan and send each facility the scoring criteria,
their performance relative to the criteria, and the monies that would have been
received by the facility using the scoring criteria.� Beginning July 1, 2010, DHMH must distribute
50% of the revenues from the quality assessment and must fully implement the
program by July 1, 2011.
By December 1, 2009, and annually thereafter, DHMH in consultation with
stakeholders, must make necessary changes to the P4P program to determine the
effect on providers and whether the measures are objective, measurable, and
(when considered in combination) have a correlation to residents' quality of
life and care.�
DHMH must also consult with stakeholders to assess the State's long-term
care reimbursement methodology and whether it is prospective and predictable,
promotes quality and efficiency, and considers severity.� DHMH must also consider alternative
reimbursement mechanisms, the P4P program, and quality and outcome-based
measures.� DHMH must report its findings
to the General Assembly by October 1, 2010.
Effective Date:� June 1, 2009
Signed by the Governor on 5/7/2009; Chapter #417
& 418
For more information, please contact:�
Sheila Higdon
SB0761 �Department of Health and Mental Hygiene - Federal
Waiver - Waiver for Medicaid Coordinated Long-Term Care Program
SB 761 requires the Secretary of Health and
Mental Hygiene to convene a group of stakeholders to review and make recommendations
reforming the provision of long-term care services under the Medicaid program
and other state programs.� The workgroup
is directed to issue an interim report of its findings and recommendations by
December 1, 2009, and issue a final report the following December.� Specifically, the workgroup will consider the
feasibility of creating a coordinated long-term care program within the
state-funded programs and draft any recommended legislation including, if
deemed appropriate, a timeframe for submitting a federal waiver to implement a
long-term care program.
Effective Date:� June 1, 2009
Signed by the Governor on 5/7/2009; Chapter #308
For more information, please contact:�
Sheila Higdon
HEALTH CARE FACILITIES/HEALTH
CARE ADMINISTRATION
The
Maryland False Health Claims Act, a
departmental bill defeated last session on the Senate floor, returned this
session. The False Health Claims Act would allow the state to bring civil
suit for fraudulent claims and allow private parties with knowledge of
fraudulent claims to bring qui tam actions on behalf of the state. The
bill heavily incentivizes whistle blowing, imposes treble damages, and could
require the implementation of duplicative procedures to ensure compliance with
the law. This year’s bill was �introduced on behalf of the Governor and at
the request of the Secretary of Health and designated $22 million in the DHMH
budget as being contingent on passage of the bill and funds recovered from
health care fraud. The bill was given a favorable report by the Senate
Judicial Proceedings Committee, but again failed on the Senate floor in a 23 to
24 vote. Because of the potential increased cost and risk to providers,
we worked with the Maryland Hospital Association, MedChi, and a number of
health care provider groups who are opposed to this legislation to secure the
votes needed to defeat the bill. Following the bill’s failure,
a supplemental budget bill was introduced that contained cuts of $20 million to
hospitals and $9.5 million to health care providers, contingent on the failure
of false claims legislation. Subsequently, opponents of the bill met with
the Health Secretary in an effort to reach a compromise, but no consensus was
reached before Sine Die. This issue is expected to return next year.
In
response to the fatal medevac helicopter
crash last fall, legislation was passed to restructure and evaluate the state
medevac and emergency medical services (EMS) system. The new legislation
increases the membership of the EMS board to 13 by adding a helicopter pilot
and member of the general public, and establishes the Joint Oversight Committee
on Emergency Medical Services. The Committee is charged with providing
legislative oversight of state emergency medical services by monitoring
protocol changes, safety improvements, and reviewing efforts to implement
recommended changes. In conjunction with other state agencies, the Committee
is responsible for examining the current funding structure and developing a
long term financing plan and reporting its findings to the General Assembly
annually.
Bills
that would have delayed the purchase of new medevac helicopters until at least
April 30, 2011, privatized the medevac system, and allowed reimbursement to
private helicopter companies were unsuccessful.
The Rural Trauma Center Bill, which caused much debate and tension among Maryland trauma care and emergency medical system stakeholders, passed. The legislation authorizes the use of surplus funds from the Maryland Trauma Services Fund to reimburse Level III trauma centers and increases the maximum on-call trauma hours for Level III trauma centers from 35,040 to 70,080. Due to the state’s current fiscal crisis, $17 million of the $20 million surplus was taken to help balance the general fund budget leaving a $3 million surplus in the fund. Since by law $3 million of the fund surplus is allocated to trauma equipment grants, this legislation authorizing surplus funds to reimburse Level III trauma centers was not funded this year.
A
bill aimed at making patients aware of their privacy rights under HIPAA was
unsuccessful.� House Bill 386 – Physicians – Patient Health Information
Privacy Rights – Form and Distribution would have required that
physicians in private medical offices distribute easy to understand information
to patients about how their health information will be protected by the HIPAA
privacy rule and provide notification to patients about his or her right to
have a copy of their medical record.�
In
reaction to Baltimore Sun articles regarding hospital billing and collection, legislative leaders worked with
hospitals, the Health Services Cost Review Commission (HSCRC), and the
Governor’s office on legislation to equitably address the concerns raised
in the article. Identical bills passed both chambers and took effect June
1, 2009. The legislation requires hospitals to provide free, medically
necessary care to patients whose income is at or below 150% of the FPL.
In addition, the bill permits the HSCRC to establish a threshold of up to 200%
of the FPL, but requires the agency to take into account the patient mix
of the hospital, the financial condition of the hospital, the level of bad debt
experienced by the hospital, and the amount of charity care provided by the
hospital before altering the threshold. The legislation also establishes
an HSCRC workgroup that includes stakeholders, to review the need for uniform
policies related to patient financial assistance and debt collection among all
hospitals, the use of liens to enforce collection of a debt, the desirability
of applying uniform policies to private psychiatric and chronic care hospitals,
and the desirability of altering the legal rate of interest on a judgment to
collect a hospital debt. Finally, the bill requires hospitals to provide
an information sheet which details the hospitals’ financial assistance
policy and the methods by which individuals may seek assistance.
Separate
legislation requires every hospital to submit its most recent IRS Form 990s to the HSCRC on an annual
basis.
A
number of bills that would have had an adverse impact on hospitals and health
care providers failed. Among them was a bill prohibiting hospitals from
charging interest or late payment fees at a rate exceeding 5% annually.
Other bills attempting to amend current statute prohibiting so-called
“self referral” for radiation therapy and radiology services also
failed, as did bills establishing additional reporting of MRSA and other
hospital-acquired infections, and bills that would have mandated when and how
physicians must communicate with patients regarding end of life care.
Legislation
has passed requiring the Maryland Health Care Commission (MHCC) to develop a
coordinated public-private approach, with stakeholder input, to improve the
state’s health information
infrastructure, aligning funding opportunities under the federal stimulus
bill and private sector initiatives relating to health IT by January 1,
2011. The bill also authorizes the MHCC to develop regulations to require
private payors to incentivize providers to adopt electronic health records, and
requires the MHCC and the HSCRC to designate a health information exchange for
the state by October 1, 2009.
In
the waning days of the 2008 legislative session, the Prince George’s County Hospital Authority (Authority) was
established, and provided that if the Authority had not reached a final agreement
on the transfer of the Prince George’s County Health Care System (System)
within a specific time frame, the state and county would be relieved of their
financial commitments to the System.�
Although a final agreement was not reached, bids have been received, and
legislation was necessary to allow the Authority to continue its work.� Therefore, legislation was enacted this
session that permits the Authority to extend the bidding process for the
System, authorizes the MHCC to issue an exemption from the CON process,
requires the Authority to determine whether any single bid or combination of
bids meet the specified requirements to transfer assets of the System, and
permits the System’s assets to be sold separately as long as all components are transferred
simultaneously.� The bill also adds
advisors to the Authority, including representatives from DHMH, the Prince
George’s County Health Department, MHCC, MHHEFA, the Department of
Business and Economic Development, the Prince George’s Economic
Development Corporation, the Maryland Life Sciences Advisory Board, the
Governor’s Office of Homeland Security, and the Community Health
Resources Commission.
Please
find details on relevant bills which passed below.
HB0070� Department of Health and Mental Hygiene - Commissions,
Programs, and Reports - Revision
HB 70 repeals a number of commissions, councils,
programs, and task forces within DHMH, and repeals and consolidates a number of
reports required by DHMH.� Among those
consolidated are reports on oral health and physician’s fees.
Three oral health reports are combined so that DHMH and the Office of Oral
Health jointly submit one annual report to the Governor and the General
Assembly on Oral Health Program results; findings and recommendations;
availability and accessibility of dentists participating in the Maryland
Medical Assistance Program; outcomes on managed care and dental managed care
organizations under the Maryland Medical Assistance Program specified in the
bill; and the allocation and use of funds authorized for dental services under
the Maryland Medical Assistance Program.
The bill also consolidates two physician fee reporting requirements so
that DHMH submits one annual report to the Senate Finance Committee and the
House Health and Government Operations Committee on a review and comparison of
provider payment rates under the Medicare fee schedule, Medicaid
fee-for-service, and Medicaid managed care organizations (MCOs); whether fee-for-service
rates and MCO provider rates will exceed the rates paid under the Medicare fee
schedule for the period covered by the review; an analysis of the
fee-for-service reimbursement rates paid in other states and how those rates
compare with Maryland; a schedule for bringing the State’s
fee-for-service reimbursement rates to a level that assures that all health
care providers are reimbursed adequately; and an analysis of the estimated
costs of implementing the schedule and any proposed changes to the
fee-for-service reimbursement rates for the Maryland Medical Assistance Program
and Maryland Children’s Health Program (MCHP).
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter
#656
For more information, please contact:�
Sheila Higdon
HB0487� State Health Services Cost Review Commission - Health
Care Facilities - Required Forms
HB0487 requires each health care facility to
submit annually to the HSCRC the most recent Form 990 that the facility has
filed with the Internal Revenue Service.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #398
For more information, please contact:�
Sheila Higdon
HB1150� Health Occupations - Anatomic Pathology Services -
Billing
HB 1150 authorizes� a clinical laboratory, a physician, or a
group practice that provides anatomic pathology services on a PAP test specimen
for a patient in the State to present a bill for services to a referring
physician who orders but does not supervise or perform an anatomic pathology
service on a pap test specimen.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#163
For more information, please contact:�
Delora Sanchez
SB0464/HB0521� Maryland Trauma Physician Services Fund - Rural Trauma
Centers - Reimbursement
SB 464/HB 521 authorizes the use of excess or
surplus funds from the Maryland Trauma Services Fund to reimburse Level III
trauma centers for the costs incurred to maintain trauma physicians and will
increase the maximum on-call trauma hours for Level III trauma centers from
35,040 to 70,080.� Reimbursement to Level
III trauma centers is contingent upon the availability of surplus funds.� Previously the trauma fund surplus was used
to provide grants to Level II and Level III centers for trauma equipment.� This year there will be no allocation for
equipment grants.� Due to the State's
current fiscal crisis, the trauma fund surplus of $17 million was tapped to
help to balance the general fund budget, leaving $5 million in the trauma fund
surplus.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter
#547
For more information, please contact:�
Delora Sanchez
SB0492/HB0411� Community Mental Health Services Programs - Financial
Statements and Salary Information
SB 492/HB 411 requires a community mental health
services program to submit annual financial statements and salary information
in accordance with Mental Hygiene Administration guidelines.� It also permits MHA to impose a penalty of
$500 per day for failure to comply.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #72
& 73
For more information, please contact:�
Sheila Higdon
SB0493/HB0412� Mental Health Programs and Facilities - Reports of
Death
SB 493/HB 412 authorizes Mental Hygiene
Administration (MHA) facilities and programs that operate more than one
treatment program to make only one death report if a person who attends more
than one treatment program dies.� In
addition, if the death occurs in a nonresidential psychiatric rehabilitation
program, the administrative head of the program must report the death to the
MHA director by the close of business of the next working day. The bill also
limits the programs and facilities that are subject to death reporting
requirements to inpatient or residential treatment settings, residential crisis
services, group homes, and residential rehabilitation programs.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #74
& 75
For more information, please contact:�
Sheila Higdon
SB0640/HB0526� Credentialing of Health Care Providers by Managed Care
Organizations, Insurance Carriers and Hospitals
SB 640/HB 526 authorizes each hospital to use
one of two uniform credentialing forms for credentialing physicians: (1) the
form designated by the Secretary of Health and Mental Hygiene; or (2) the uniform
credentialing form designated by the Maryland Insurance Commissioner. The
Commissioner is authorized to designate a specified provider credentialing
application if the application is available to providers at no charge and use
of the application is not conditioned on submitting the application to a
carrier through a specified online credentialing system.� Managed care organizations are also added to
the list of carriers subject to uniform credentialing requirements.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #90
& 91
For more information, please contact:�
Sheila Higdon
SB077/HB1069� Health Services Cost Review Commission - Financial
Assistance and Debt Collection Policies
SB 776/HB 1069 alters the requirements for
hospital financial assistance and debt collection policies, requires that
hospitals develop an information sheet to provide to patients and their
families, and requires the Health Services Cost Review Commission (HSCRC) to
convene a workgroup to address collection policies and other related
issues.�
Hospitals must develop a financial assistance policy for providing free
and reduced-cost care to patients who lack sufficient health care
coverage.� At a minimum, the policy has
to provide free care to patients with family income up to 150% of federal
poverty guidelines (FPG) and reduced-cost care to low-income patients with
family income above 150% FPG, in accordance with the mission and service area
of the hospital.� The HSCRC may establish
higher income thresholds by regulation.�
A hospital must post notice of its financial assistance policy in the
billing office.
Each hospital must develop an information sheet that:
(1)
describes the hospital’s financial assistance policy;
(2)
describes a patient’s rights and obligations with
regard to hospital billing and collection;
(3)
provides contact information on how to access assistance;
(4)
provides contact information for the Medicaid program; and
(5)
includes a statement that physician charges are billed
separately.
The information sheet must be given to the patient or a representative of
the patient at specified times and must be referenced on the hospital
bill.� The HSCRC must establish uniform
requirements for the information sheet and review each hospital’s
compliance.� Each hospital must also
ensure the availability of staff who are trained to work with the patient or a
representative of the patient to understand billing issues and how to apply for
Medicaid and other programs that may help pay the hospital bill.
Each hospital must submit to the HSCRC the hospital’s debt
collection policy. The policy must:
(1)
provide for active oversight by the hospital of any contract
for collection of debts on behalf of the hospital;
(2)
prohibit the hospital from selling any debt;
(3)
prohibit the charging of interest on bills incurred by
self-pay patients before a court judgment is obtained;
(4)
describe in detail the consideration by the hospital of
patient income, assets, and other criteria;
(5)
describe the hospital’s procedures for collecting a
debt; and
(6)
describe the circumstances in which the hospital will seek a
judgment against a patient.
The HSCRC must review each hospital’s implementation of and
compliance with these policies.
The HSCRC must establish a workgroup on patient financial assistance and debt
collection to review the need for uniform policies among hospitals. The agency
must also study and make recommendations on incentives for hospitals to provide
free and reduced-cost care to patients without the means to pay their hospital
bills. The workgroup must report its findings and recommendations, including
recommendations for legislation to the Governor and General Assembly, by
October 1, 2009.� Their study must
address the potential need for uniform policies among hospitals relating to
patient financial assistance and debt collection, including as elements within
any uniform policy:
(1)
income thresholds and any special treatment of disability and
pension incomes,
(2)
asset thresholds and treatment of various types of assets,
(3)
use of liens to enforce collection of a debt,
(4)
collection procedures,
(5)
establishment of guardianship,
(6)
use of judgments to collect debts,
(7)
patient education and outreach to inform patients of the
availability of financial assistance with their bills,
(8)
the desirability of applying any uniform policies to private
psychiatric and chronic care hospitals, and
(9) the desirability of
altering the legal rate of interest on a judgment to collect a hospital debt.
Effective Date:� June 1, 2009
Signed by the Governor on 5/7/2009; Chapter #310
& 311
For more information, please contact:�
Sheila Higdon
SB0874/HB0415� Mental Hygiene Administration - Rights of Individuals
with Mental Disorders in Facilities
SB 874/HB 415 allows an individual in a mental
health facility to designate an advocate to participate in the treatment and
discharge planning process except when the individual is a child or disabled
adult whose legal guardian has requested in writing that a specific advocate
not participate.� The bill requires an
individual in a mental health facility to receive treatment in accordance with
his or her advance directive and clarifies use of restraints.� Finally, the bill places conditions on
advocate participation and prohibits the bill’s provisions from being
construed to grant certain authority not otherwise in law, or limit authority
established elsewhere in law.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter
#621
For more information, please contact:�
Sheila Higdon
SB1039/hb1486� Prince George's County Hospital Authority
SB 1039/HB 1486 expands the mission of the
authority to include extending the bidding process. The State and Prince
George’s County must be relieved of some or all of their long-term
funding obligations to support the system (1) only to the extent that any fund
balance remaining after the transfer of all of the system’s components to
a new owner(s); or (2) after the authority has expired without agreement on the
transfer of all of the system’s components to a new owner(s).
The MHCC may issue a CON exemption and waive the requirements of the State
Health Plan to facilitate a recommendation by the authority to relocate beds or
services of all or part of a facility in the system.�
The authority must assess any bid or combination of bids to determine (1)
whether any bid or combination of bids satisfies the authority’s mandate
to transfer the system in its entirety to a new owner(s); and (2) whether one
or more bidders would be capable of meeting specified requirements and has
submitted a bid that meets those requirements. If the authority determines that
any bid or combination of bids satisfies specified requirements, and after
consultation with stakeholders, the authority must proceed toward a final
agreement on the transfer of the system and notify stakeholders. The authority
must complete these obligations prior to the expiration of the authority.
To facilitate the transfer of the system, multiple agencies have to
designate individuals to serve as advisers to the authority. They include DHMH,
the Prince George's County Health Department, MHCC, HSCRC, Department of
Business and Economic Development, Prince George's County Economic Development
Corporation, Maryland Health and Higher Education Financing Authority, Maryland
Institute of Emergency Medical Services System, Governor's Office of Homeland
Security, the Community Health Resources Commission and the Maryland Life
Sciences Advisory Board.� Advisers must,
to the extent specifically requested by the authority, assist with (1) the
evaluation of any proposals; and (2) discussions and negotiations with any
bidders.
The bill also expresses legislative intent that the authority continue its
bid review process and proceed toward a final agreement on the transfer of the
system.� Any agreements in effect on
January 1, 2009, including financial commitments on the part of the State and
county, relating to the transfer of the system must remain in effect.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#116 & 117
For more information, please contact:�
Sheila Higdon
Legislation expanding the existing loan assistance repayment program for physicians passed, creating
an expanded program that will assist in repaying loans for physicians who
practice primary care in specific geographic areas in the state for at least
two years. Primary care for the purpose of this program is defined as
family medicine, internal medicine, obstetrics, pediatrics, geriatrics,
emergency medicine, and psychiatry. The majority of the funding for this
program will be generated through an increase in hospital rates, as approved by
the HSCRC and CMS. Following approval, the HSCRC will work with the
Maryland Higher Education Commission to develop a process for physicians to
apply for the loan assistance program.
In
an effort to streamline the credentialing
process for physicians and reduce requests for redundant information,
legislation passed permitting hospitals to use either the credentialing form
designated by the Secretary of the Department of Health and Mental Hygiene, or
the uniform credentialing form designated by the Maryland Insurance
Administration (MIA).
The
shortage of non-physician anesthesia care providers prompted the introduction
of legislation to license Anesthesiologist
Assistants in Maryland.� Legislation
involving scope of practice issues has historically been contentious and
generally takes several legislative sessions to pass.� The Maryland Anesthesiologist Assistants Act
enjoyed a positive hearing in the Senate but was subsequently withdrawn in the
House.� The bill has been sent to summer
study in the Senate; we will continue to work with the sponsor during the
interim to gain support for the legislation in anticipation of next
session.��
Legislation
passed that will extend the deadline for a Polysomnographic
Technologist licensing requirement from 2009 to 2011.� The extension was critical for Johns Hopkins
as several sleep laboratories and studies are conducted by polysomnographic
technologists and additional time is required to obtain licensure without
jeopardizing funding for research.� The
committee is planning to study the impact of this law on sleep research
activities in the State.
In
an effort to help alleviate the nursing
shortage, the State Board of Nursing introduced a departmental bill that
would have granted nurses licensed in other states and abroad alternatives to
the traditional licensing process in Maryland.�
The bill failed after strong opposition from members of the nursing
community who contended that if passed the bill would diminish patient safety
and quality of care.� Legislation passed
that will authorize nurse practitioners
to fill out and sign death certificates. �Language that would have authorized nurse
practitioners to make determinations of incapacity or debilitation was amended
out of the bill.
Legislation
was passed during the 2008 session establishing the Task Force on Discipline of
Health Care Professionals and Improved Patient Care to study and make
recommendations on issues surrounding Maryland’s 18 health occupations
boards. The primary purpose of the Task Force was to determine
uniform discipline and sanctioning standards for the boards. The Governor
appointed Patricia Brown, J.D., President of Johns Hopkins Health Care as chair
of the Task Force. Over the 2008 legislative interim, the Chair and
members of the task force held several meetings and studied the practice of
health occupations boards in surrounding states and the current discipline
practices of the Maryland boards. The Task Force made its recommendations
to the Governor and General Assembly in February 2009.
Legislation
was introduced this session to implement the task force recommendations.
The recommendations included but were not limited to: standardized guidelines
and process for the disciplinary sanctions; filling of board vacancies;
membership; training; data sharing and collection; and board authority.
Lengthy hearings were held in the House and the Senate as many amendments were
offered by the directors of health occupational boards. Unfortunately
despite the diligent work of the Chair and the task force members, the
legislation to implement the recommendations was unsuccessful as legislators,
board members, and interested stake holders could not reach a consensus as to
what amendments should be adopted. It is anticipated that the bill will
be reintroduced during the 2010 session.
Other
failed bills include one that would have required physicians to maintain
medical professional liability insurance in the amount of $500,000 per
occurrence or claim and $1,500,000 per annual aggregate and a bill that would
have established a task force to consider the regulation of surgical first assistants
and make recommendations regarding the creation of a licensing process for
surgical first assistants in Maryland.
Please
find details on relevant bills which passed below.
HB0173 �Health Occupations - Maryland Athletic Trainers Act
HB 173 establishes an athletic trainer license
and the Athletic Trainer Advisory Committee.�
The practice of athletic training is defined as the application of
methods for managing athletic injuries including prevention, clinical
evaluation and assessment, immediate care, treatment, rehabilitation,
reconditioning, administration of athletic training programs, and instruction
regarding the care and prevention of athletic injuries.� It does not include the practice of
chiropractic, massage therapy medicine, occupational therapy, physical therapy,
or the reconditioning of systematic neurologic injuries, conditions, or
disease.� Licensed athletic trainers will
be authorized to practice athletic training in an approved setting in accordance
with an evaluation and treatment protocol between the athletic trainer and a
licensed physician.
Effective Date:� October 1, 2009
Signed by the Governor on con 5/15/2009; Chapter
#530
For more information, please contact:�
Delora Sanchez
HB0374 �Radiation Therapists, Radiographers, Nuclear Medicine
Technologists, and Radiologist Assistants - Renewal Requirements for Licenses
HB 374 repeals the renewal requirement for
licensed radiation therapists, radiographers, nuclear medicine technologists,
and radiologist assistants and requires that they meet any additional renewal
requirements established by the board.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#138
For more information, please contact:�
Delora Sanchez
SB0433/HB0597
�State Board of Physicians - Polysomnographic
Technologists - Education and Licensing Requirements
SB 433/HB 597 alters the date by which an
individual must be licensed before they may practice polysomnography from
October 1, 2009 to October 1, 2011.� It
also alters the date by which the Board of Physicians will waive the education
requirements for polysomnographic technologists from September 30, 2009 to
September 30, 2011.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #262
For more information, please contact:�
Delora Sanchez
SB0602/HB0576
�Dental Hygienists - Expanded Functions
SB 602 authorizes dental hygienists to
administer local anesthesia and perform a manual curettage.� Dental hygienists may administer local
anesthesia under the supervision of a dentist and not as a medical
specialty.� Dental hygienists must
successfully complete any educational requirements and clinical examinations
established by the Board of Dental Examiners before administering local
anesthesia.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #565
& 566
For more information, please contact:�
Delora Sanchez
SB0627/HB0714
�Loan Assistance Repayment and Practice Assistance for
Physicians
SB 627/HB 714 removes physicians from the
existing loan assistance repayment program (the Janet L. Hoffman Loan
Assistance Repayment Program [LARP-PCS]) and establishes the Maryland Loan
Assistance Repayment Program for Physicians (Program).� Funding for the new program will be via
reallocation of existing funds in the LARP-PCS program as well as a hospital
rate increase, which must be approved by the HSCRC and CMS.� Fund expenditures must be made through an
appropriation in the state's annual budget.
Upon funding approval the Office of Student Financial Assistance (Office)
within the Maryland Higher Education Commission, in collaboration with the
Department of Health and Mental Hygiene (DHMH), will adopt regulations that
establish the maximum number of participants in the Program each year in each
priority area, and the minimum and maximum amount of a loan awarded in each
priority area.� Funding priority will be
as follows:�
(1)
Primary care physicians who are employed in geographic areas
of the state that have been federally designated,
(2)
Medical residents specializing in primary care who agree to
practice for at least 2 years in geographic areas of the state that have been
federally designated,
(3)
Physicians practicing primary care in a geographic area of
the state where DHMH has identified a shortage of primary care physicians, and
(4)
Physicians practicing a medical specialty other than primary
care in a geographic area where DHMH has identified a shortage of that
specialty.
Primary care is defined for the purposes of this program as family
medicine, internal medicine, pediatrics, geriatrics, emergency medicine, and
psychiatry.�
In addition, the Maryland Health Care Commission and the Department of
Business and Economic Development must report to the General Assembly by
December 1, 2009 on the feasibility of expanding the eligibility criteria of
State development programs to include providing assistance to physician
practices in medically underserved areas in the State, and the feasibility of
making economic development funding available for physician practices evolving
to medical homes.
Effective Date:� July 1, 2009
Signed by the Governor on 5/19/2009; Chapter #575
& 576
For more information, please contact:�
Sheila Higdon
SB0628/HB0510
�Health Occupations - Licensure of Social Workers
SB 638/HB 510 requires the State Board of Social
Work Examiners to notify applicants for licensure 60 days after the date the
applicant submitted their application to the board whether the applicants have
been approved or denied the opportunity to take the pertinent licensure examination.� It also requires the Board of Social Work
Examiners to create a workgroup to make recommendations to the General Assembly
on the licensure statute, the licensing process, and issues affecting the
status of workforce in the state.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #*6
& 87
For more information, please contact:�
Delora Sanchez
SB0700 �Pharmacists - Administration of Vaccinations -
Expanded Authority
SB 700 expands the authority of pharmacists to
administer pneumococcal pneumonia or herpes zoster, or any other vaccination
that has been determined appropriate by the Board of Pharmacy, with the Board
of Physicians and the Board of Nursing, to be in the best health interests of
the community.� The Boards are required
to meet annually to jointly develop, adopt, and review new regulations that
must include provisions for pharmacists to submit registration forms to the
Board.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #304
For more information, please contact:�
Delora Sanchez
SB0759/HB0250
�Public Health - Certificates of Death - Nurse
Practitioners
SB 759/HB 250 authorizes a nurse practitioner to
sign and fill out information on death certificates.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #599
& 600
For more information, please contact:�
Delora Sanchez
HEALTH INSURANCE/HEALTH
CARE ACCESS
As
a result of the work of the Task Force on Health Care Access and Reimbursement,
bills passed addressing a number of physician reimbursement and health
insurance modification issues which the legislature has been debating for the
past few sessions.� These bills include:
physician credentialing, HMO payments to nonparticipating physicians, and use
of physician rating systems.
A
bill passed altering the rates that an
HMO must pay for covered services by a non-participating provider, and
requires that the HMO pay no less than 125% of the average rate the HMO pays in
the same geographic area or 140% of the Medicare rate for evaluation and
management services, whichever is higher.�
In addition, the bill requires that the HMO pay no less than 125% of the
average rate the HMO pays in the same geographic area for any other covered
service, and authorizes the MIA to investigate and enforce a violation of the
bill.
Legislation
authorizing carriers to use a physician
rating system passed, but requires the system to be based on both quality
of performance and cost efficiency.� It
also provides that a physician rating system cannot be implemented until the
carrier has that system reviewed by a rating examiner, who reports to the
Attorney General’s Office and the MIA regarding the methodologies used
and compliance with the bill.
Finally,
a bill passed that clarifies that an insurance carrier must pay a clean claim
within 30 days of receipt of the claim, or must pay interest (prompt pay).� Carriers face a $500 fine per violation, and
additional penalties for frequent violations.
Despite
another strong push by the hospital and physician groups, assignment of benefits legislation permitting unilateral ability to
assign benefits directly to a health care provider failed.� However, the issue was sent to an existing
joint committee to study over the interim.
Legislation
to prohibit carriers from requiring hospital-based physicians to participate in
their network as a condition of carrier participation with the hospital (unfair trade practices) failed.
Please
find details on relevant bills which passed below.
HB0032 �Health Insurance - Limitations on Preexisting
Condition Provisions - Individual Health Benefit Plans
HB 32 expands the preexisting condition
provisions in the health insurance code, which currently only apply to group
policies, to include individual policies as well.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #653
For more information, please contact:�
Mat Palmer
HB0141 �Insurance - Insurer Provider Panels - Health Care
Providers
HB 141 prohibits an insurer from using a
provider panel if the contract for the provider panel requires a provider to
participate on the provider panel as a condition of participating on an HMO or
non-HMO provider panel.� The bill also
requires that the insurer give a provider the schedule of fees at the time of
contract, 30 days prior to a change, or upon request.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#131
For more information, please contact:�
Mat Palmer
HB0235 �Health Insurance - Rescission of Contracts and
Certificates - Restrictions
HB 235 prohibits a carrier that conditions
coverage on evidence of individual insurability from rescinding coverage on the
basis of written information submitted on, or omitted from, the application
unless the carrier completed medical underwriting and resolved all medical
questions related to the written information before issuing the health plan.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #663
For more information, please contact:�
Mat Palmer
HB0255 �Health Maintenance Organizations - Payments to
Nonparticipating Providers
HB 255 alters the rates that an HMO must pay for
a covered service by a non-participating provider.� The bill provides that the HMO pay no less
than 125% of the average rate the HMO pays in the same geographic area for the
covered service, or 140% of the Medicare rate, whichever is higher.� The bill also authorizes the Maryland Insurance
Administration to investigate and enforce a violation of the bill.
Effective Date:� January 1, 2009
Signed by the Governor on 5/19/2009; Chapter #664
For more information, please contact:�
Mat Palmer
HB0405 �Health Insurance - Mandated Benefits - Breast Cancer
Screening
HB 405 mandates coverage of mamograms and
requires insurers, nonprofit health service plans, and HMOs to provide coverage
for breast cancer screening in accordance with the screening guidelines issued
by the American Cancer Society.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #670
For more information, please contact:�
Mat Palmer
HB0440 �Health Insurance - Prompt Pay - Clarifications
HB 440 requires that, in reprocessing a claim,
an insurer, nonprofit health service plan, or health maintenance organization
(carrier) must pay the claim or send a notice of receipt with status of the
claim within 30 days of receipt. If a carrier fails to pay a clean claim or
otherwise violates clean claims requirements, the carrier must pay interest on
the amount of the claim that remains unpaid 30 days after the receipt of the
initial claim for reimbursement.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #67
For more information, please contact:�
Mat Palmer
hB0610/sb0638� Health Insurance - Bona Fide Wellness Programs -
Incentives
HB 610/SB 638 allows an insurer to condition an
incentive for their wellness program on a health factor if: the incentive does
not exceed 20% of the cost of the plan for the recipient or their dependents;
the wellness plan is reasonably designed; the wellness program incentive is
offered to all similarly situated individuals; enrollment in the wellness
program is open once per year; and the contract and all materials include full
disclosure of the terms and conditions of the wellness program.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter
#682 & 683
For more information, please contact:�
Mat Palmer
SB0173/HB0041
�Health Insurance - Mandated Benefits - Hospitalization
and Home Visits Following a Mastectomy
SB 173/HB 41 adds hospitalization and home
visits to the list of mandated health insurance benefits following a
mastectomy.� The bill provides that
insurance cover the cost of inpatient hospitalization for a minimum of 48 hours
following a mastectomy unless the patient requests a shorter stay.� If the patient receives less than a 48 hour
inpatient stay, their insurance shall cover at least one home visit.� The bill also provides that insurance is
required to cover one home visit for any patient who has received a mastectomy
if prescribed by the attending physician, regardless of the length of their
inpatient stay.� The bill also prohibits
an insurance plan from imposing a copayment, coinsurance requirement, or
deductible for coverage of these home visits.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #516
7517
For more information, please contact:�
Mat Palmer
sb0341/HB0579
�Prosthetic Parity Act
SB 341/HB 579 requires insurers, nonprofit
health plans, and health maintenance organizations to provide coverage and
payment for prosthetic devices.� Coverage
must be provided for the prosthetic device itself, as well as the repair or
replacement of a prosthetic device due to a change in the physical condition of
the insured if determined necessary by the health care provider of the
insured.� The covered benefits may not be
subject to a higher copayment or coinsurance requirement than that covered
under the policy contract.� Insurers may
not impose an annual or lifetime dollar maximum on the required coverage.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #243
& 244
For more information, please contact:�
Mat Palmer
SB0637HB0674� Health Insurance - Small Group Market Regulation -
Modifications
SB0637/HB 674 alters the Comprehensive Standard
Health Benefit Plan (CSHBP) sold in the small group market by permitting
preexisting condition limitations, repealing the benefit floor, expanding the
permissable range of rates to 50% above and 50% below the community rate, and
permitting use of health status in rating.
Effective Date: July 1, 2009
Signed by the Governor on 5/19/2009; Chapter #577
& 578
For more information, please contact:�
Mat Palmer
sb0661/HB0585
�Health Insurance - Use of Physician Rating Systems by
Carriers
SB0661/HB 585 authorizes carriers to use a
Physician Rating System if the system is based on both quality of performance
and cost efficiency.� It also provides
that a physician rating system cannot be implemented until the carrier has the
system reviewed by a rating examiner, who reports to the Attorney General's
Office and the Maryland Insurance Administration regarding the methodologies
used and the compliance of the system with the bill.
Effective Date:� October 1, 2009
Signed by the Governor on con5/19/2009; Chapter
#585 & 586
For more information, please contact:�
Mat Palmer
SB0985/HB0456
�Health Insurance - Coverage for Off-Label Use of Drugs
- Standard Reference Compendia
SB 985/HB 456 alters the definition of
"standard reference compendia" for the purposes of mandated coverage
of off-label use of drugs, to mean any authoritative compendia as recognized
periodically by the federal Secretary of Health and Human Services or the
Maryland Insurance Commissioner.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #112
& 113
For more information, please contact:�
Mat Palmer
SB1070/HB1534� Nonprofit Health Service Plans - Hearing and Order -
Impact of Law by Another State
SB 1070/HB 1534 authorizes the Maryland
Insurance Administration (MIA) to hold hearings if another state enacts a law
that requires CareFirst to provide a program or benefit.� The bill also authorizes the MIA commissioner
to issue an appropriate order to protect CareFirst subscribers in
Maryland.� This is in response to a
possible action by Washington, D.C. attempting to compel CareFirst to provide
programs or benefits in the District of Columbia.
Effective Date:� June 1, 2009
Signed by the Governor on 5/7/2009; Chapter #348
& 349
For more information, please contact:�
Mat Palmer
HEALTH - GENERAL/PUBLIC/ENVIRONMENTAL
Even
as many state programs experienced cuts, legislators were able to increase
funding for substance abuse treatment and
rates to substance abuse treatment providers by shifting funds from the Alcohol
and Drug Abuse Administration (ADAA) to the Medicaid Primary Adult Care (PAC)
program, passing the only substantial substance abuse policy change this
session.� The new legislation authorizes
the Governor to shift $3.3 million in funds beginning fiscal year 2009, making
the state eligible for $3.3 million in federal matching funds, for a total of
$6.6 million in substance abuse funding through the Medicaid fee-for-service
system and MCOs.� Providers will bill
Medicaid for payment and Medicaid rates will increase under the new law.
A
bill to carve substance abuse services
out of the Medicaid Managed Care Organizations (MCO) program and move
management of these services to the existing mental health administrative
services organization was introduced this session. Johns Hopkins
testified in opposition to the bill, which was introduced by the Chair of the
House Health & Government Operations Committee. The bill did not make
it out of committee, but will go to a workgroup in hopes of developing a
definite plan to improve the coordination of substance abuse treatment services
for next session.
With
the added momentum of federal stimulus funding, legislation that will
significantly enhance adoption of electronic health records passed.� The bill requires the Department of Health to
designate a State health information exchange by October 1, 2009, and contains
progress reporting requirements as well as a defined timeline for full adoption
and implementation of electronic health records.� In addition, the bill requires private
insurance carriers to provide incentives for adoption similar to those that
will be provided by Governmental payors via the stimulus funds.� Johns Hopkins, along with their partners in
CRISP (Chesapeake Regional Information Systems for our Patients), supported
this legislation.
Environmental
health protection bills introduced during the session dealt with everything
from mercury abatement efforts, a requirement for testing children’s toys
for lead paint, lead dust testing upon affected property turnover, diesel
emissions reduction, and indoor air quality monitoring.� Despite the plethora of well-intentioned
bills, only two such bills passed.� The
first bill has to do with Mercury switch
removal from vehicles and the second with modifications to the Children’s products containing lead statute.
Please
find details on relevant bills which passed below.
HB0076 �Hepatitis C Virus - Public Awareness and Outreach -
Repeal of Sunset
HB 76 repeals the termination (scheduled for
December 31, 2009) of the Department of Health and Mental Hygiene's hepatitis C
outreach and public awareness campaigns.
Effective Date:� July 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#125
For more information, please contact:�
Sheila Higdon
HB0093 �Mortality and Quality Review Committee - Sunset
Extension and Membership
HB 93 extends the termination date of the
Mortality and Quality Review Committee from September 30, 2009 to December 31,
2012 and removes the Deputy Secretary of Public Health as a member of the
Committee and adds the Deputy Secretary of Behavioral Health and Disabilities.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #49
For more information, please contact:�
Delora Sanchez
HB0119 �Children's Products Containing Lead - Modifications
HB 119 aligns the terms and conditions in
Maryland's statutes regarding lead in children's products with the federal
Consumer Product Safety Act of 2008.�
First, it changes the meaning of the word child to include all
individuals under 13 years of age instead of under 5 years of age.� Second, all manufacturers of children's
products must have their products tested by an independent company to affirm
that the products do not contain lead.�
Third, certification of compliance with the law must accompany the
children's product to the end user (second hand or consignment shops are
excluded from this requirement).
Effective Date:� Emergency Measure
Signed by the Governor on 4/14/2009; Chapter
#129
For more information, please contact:�
Delora Sanchez
HB0419 �Wellness Report Card Pilot Program
HB 419 establishes the Wellness Report Card
Pilot Program to identify key wellness and prevention issues in the counties
involved in the pilot program, and provide a comprehensive report comparing
certain counties in the state to each other and identifying the most important
wellness issues that need to be addressed to promote wellness and disease
prevention.� DHMH will designate the
entity to establish the Wellness Report Card established in the pilot program,
and that entity will determine which counties in the state will be involved in
the pilot program.� The Wellness Report
Card will evaluate the health status of each county in the pilot program by
ranking the county within specific health indicator categories and comparing
each county to the state and to comparable counties in the U.S.�
The bill also directs the University of Maryland School of Public Health,
using existing staff, to:
(1)
provide a forum for stakeholders to engage in active
collaboration to enhance the health and well-being of residents in the counties
involved in the pilot program,
(2)
analyze the results of the Wellness Report Card and develop a
strategic plan to develop solutions to the wellness issues identified in the
Wellness Report Card, and
(3)
ensure effective implementation of programs and priority
health promotion and disease prevention issues as defined by the Wellness
Report Card.�
This Act sunsets in September 2014.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #671
For more information, please contact:�
Sheila Higdon
HB0507 �Inmates - Hepatitis C - Counseling and Referral to
Medical Home
HB 507 requires the Department of Public Safety
and Correctional Services (DPSCS) to work in collaboration with the Departments
of Human Resources (DHR) and Health and Mental Hygiene (DHMH) to provide
counseling to inmates with hepatitis C.�
It also instructs DPSCS to develop a standardized process for the
referral of inmates diagnosed with hepatitis C to DHMH for enrollment in
Maryland Medicaid or Maryland's Primary Adult Care Program upon release from
jail or prison.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#142
For more information, please contact:�
Sheila Higdon
HB0706 �Electronic Health Records - Regulation and Reimbursement
HB 706 requires the Maryland Health Care
Commission (MHCC) and the Health Services Cost Review Commission (HSCRC) to
designate a State health information exchange (HIE) by October 1, 2009.
In addition, MHCC also must adopt regulations requiring “State-regulated
payors” to: provide incentives to providers to promote the adoption and
meaningful use of electronic health records (EHRs); designate one or more
management service organizations (MSO) to offer HER services; and submit
progress reports.
By September 1, 2011, MHCC, in consultation with specified stakeholders,
must adopt regulations that require State-regulated payors to provide
incentives to health care providers to promote the adoption and meaningful use
of EHRs. Any incentives must have monetary value, facilitate the use of EHRs,
recognize and be consistent with existing payor incentives regarding EHRs, and
take into account incentives under Medicare and Medicaid and available federal
grants or loans.
By October 1, 2012, MHCC must designate one or more MSO to offer HER
services throughout the State. MHCC may use federal grants and loans to help
subsidize the use of the designated MSOs by health care providers.
By January 1, 2010, MHCC must report on progress in implementing an HIE
and adopting regulations regarding incentives to providers to adopt and use
HER; and, by January 1, 2011, following consultations with stakeholders, MHCC
must submit a report covering:
(1)
the development of a coordinated public-private approach to
improve the State’s health information infrastructure;
(2)
any statutory changes necessary to protect the privacy and
security of specified health information;
(3)
any statutory changes necessary to provide for effective
operation of an HIE;
(4)
any actions necessary to align funding opportunities under
the American Recovery and Reinvestment Act (ARRA) with other initiatives
related to health information technology; and
(5)
recommended regulatory language.
The Senate Finance Committee and the House Health and Government
Operations Committee must be given 60 days for review and comment on this
report. The report must be posted on the MHCC web site for public comment.
By October 1, 2012, MHCC must report on progress achieved toward adoption
and meaningful use of EHRs by health care providers and recommendations for any
statutory changes necessary to achieve optimal adoption and use.
Finally, the bill requires the HSCRC, in consultation with hospitals,
payors, and the federal Centers for Medicare and Medicaid Services (CMS), to
assure that hospitals receive payments provided under ARRA and implement any
changes in hospital rates required by CMS to ensure compliance with ARRA. DHMH,
in consultation with MHCC, has to develop a mechanism to assure that health
care providers that participate in Medicaid receive the payments provided for
adoption and use of HER technology under ARRA.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #689
For more information, please contact:�
Sheila Higdon
HB0739 �Maryland Medical Assistance Program - Substance Abuse
Services
HB 739 will transfer $3.3 million from the
Alcohol and Drug Abuse Administration to the Medical Care Programs
Administration to expand coverage of substance abuse treatment services to the
Primary Adult Care Program and enhance rates for Medicaid substance abuse
services enabling the state to receive matching federal funds.� Providers will bill Medicaid for payment and
Medicaid rates will increase.
Effective Date:� June 1, 2009
Signed by the Governor on pass; Chapter #332
For more information, please contact:�
Delora Sanchez
HB1263 �Mercury Switch Removal from Vehicles
HB 1263 sets rules for the removal of mercury
switches from end-of-life vehicles.�
Mercury is a hazardous chemical which persists in the environment and
can be toxic when leached into water sources or soil.� The bill requires that vehicle manufacturers
submit a mercury minimization plan to the Maryland Department of Environment in
order to increase the mercury switch removal rate from such vehicles to greater
than 90%.� Financial and criminal
penalties are set for companies or persons who are found to be in violation of
the full terms of this bill.
Effective Date:� Various
Signed by the Governor on 5/19/2009; Chapter #713
For more information, please contact:�
Delora Sanchez
HB1273 �Criminal Procedure - Medical Emergency After Alcohol
or Drug Ingestion - Mitigating Factor
HB 1273 provides that the act of seeking medical
assistance for an individual that is experiencing an alcohol and drug overdose
may be used as a mitigating factor in a subsequent criminal prosecution.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #714
For more information, please contact:�
Delora Sanchez
HB1468 �Public Health Surveillance - Confidentiality
HB 1468 strengthens the level of confidentiality
associated with public health surveillance of reportable communicable diseases
as required by the Secretary of Health.�
The notable change is that "reportable data is not discoverable or
admissible as evidence in any civil or criminal matter except in accordance
with a court order sealing the court record."� However, de-identified, aggregate information
can be used in publicly distributed reports.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #470
For more information, please contact:�
Delora Sanchez
SB0963/HB0503
�Health - Maryland Commission on Autism
SB 963/HB 503 establishes a Maryland Commission
on Autism which shall advise and make recommendations concerning services for
individuals with autism spectrum disorders (ASD); develop a statewide plan for
an integrated system of training, treatment, and services for individuals with
ASDs; and evaluate ways to promote ASD awareness.� The bill establishes the qualifications for
membership on the commission and sets a date of September 30, 2012 for a report
on its final findings and recommendations.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #338
For more information, please contact:�
Sheila Higdon
SB1054 �State Advisory Council on Quality Care at the End of
Life - Membership
SB 1054 adds a representative of the nursing
home industry to the membership of the State Advisory Council on Quality Care
at the End of Life.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter
#118
For more information, please contact:�
Sheila Higdon
HIGHER EDUCATION/FINANCIAL
AID
The
dominant issue during this session was the ability of all segments of higher
education to retain the much-needed funding which they receive through the
State budget.� The legislature was able
to provide a small increase for all segments of higher education, despite the
significant budget shortfall.� However,
because of these budgetary pressures, the legislature did not pass an omnibus
bill of recommendations designed by the Commission to Develop the Maryland
Model for Higher Education Funding.� This bill codifying the findings of the
commission, and instituting a new funding model for the four public
institutions, is anticipated to return next year, and eventually be passed by
the legislature.
A
number of bills attempting to address the rising cost of college textbooks were introduced. In conjunction
with the USM, MICUA, and MHEC, we worked to educate legislators on the
provisions which were included in the federal Higher Education Opportunity Act
(HEOA) and their affect on Maryland institutions. The legislation which
did pass requires all institutions of higher education bookstores to publish
textbook information (including title, author, publisher, edition, ISBN, etc.)
on their website, no later than three weeks after the faculty member submits
their final selection.� All institutions
are required to release that information to any outside bookstore no later than
one week after the final selection by the faculty member.�� The legislation has a number of other
provisions which affect public institutions and textbook publishers.
Emergency
legislation (which goes into effect the day it is signed by the Governor)
called the Maryland Uniform Prudent Management of Institutional Funds Act (UPMIFA) passed this year.� The Governor signed the bill April 14th.�
The bill modernizes the current
Maryland Uniform Management of Funds Act and, as a uniform act, emulates the
laws of many other states.� It updates
various provisions regarding institutional funds, management and investment
conduct, and cost management, such as establishing a standard of
“ordinary business care and prudence under the existing, prevailing facts
and circumstances,” eliminating the historic dollar value concept,
establishing a rebuttable presumption of imprudence for spending more than 7%
of an endowment fund in any year, and other modifications.
More than 25
states have passed UPMIFA in slightly differing forms. Unfortunately, one
provision in the model act may affect the accounting for some of our more long
standing Johns Hopkins endowments. �This
is an issue that will require clarification with appropriate state regulators
or an adjustment to the model act in the next legislative session.
Please find
details on relevant bills which passed below.
HB0200� Maryland Uniform Prudent Management of Institutional Funds
Act
HB 200 replaces the current Maryland Uniform
Management of Institutional Funds Act with the new Act which provides modern
articulation of the prudence standards for the management and investment of
charitable funds and for endowment spending.�
Specifically the Act gives updated and more useful guidance for
management and investment of institutional funds; improves the protection of
donor intent with respect to endowment spending; improves endowment spending
requirements by eliminating the "historic dollar value" concept and
instead provides better guidance with respect to the operation of the prudence
standard; and updates provisions regarding the release or modification of fund
restrictions to allow for more efficient management of a fund.
Effective Date:� Emergency Measure
(Effective upon enactment)
Signed by the Governor on 4/14/2009; Chapter
#134
For more information, please contact:�
Mat Palmer
SB0556/HB1192
�State Funding Accountability Act
SB 556/HB 1192 requires specified grantees to submit
a report to the Department of Information Technology (DoIT) by September 1
after each fiscal year in which the grantee receives State aid. DoIT must
develop and operate a searchable web site, accessible to the public at no cost,
which provides grantee report information in a specified format. The Office of
Legislative Audits (OLA) is authorized to conduct audits or reviews of
grantees.
A “grantee” is a for-profit or nonprofit entity or association
that receives State aid during a fiscal year and is not a unit of State or
local government. “State aid” is a contribution, grant, or subsidy
of $50,000 or more provided through the State operating or capital budget or by
the action of a unit of State government from State funds appropriated to that
unit. “State aid” does not include reimbursements to providers
participating in a State program.
Grantee reports must contain the following information:
(1)
a summary of the purpose for which the State aid was
provided;
(2)
the number of jobs created or retained as a result of the
State aid;
(3)
the amount and source of any funds, other than State aid, the
grantee secured for the same purpose for which the State aid was provided, or
as a result of the State aid;
(4)
a description of how the State aid served the citizens of the
State; and
(5)
the number of citizens served as a result of the State aid.
The web site must provide all information contained in grantee reports and
be searchable by, at a minimum, the name of grantee and the general subject
matter of the State aid. Nonpublic institutions of higher education that
receive specified aid must submit a report to the Maryland Independent College
and University Association (MICUA) by September 1 after each fiscal year in
which they receive aid with the following information:
(1)
a summary of the purpose for which the State aid was
expended;
(2)
a description of how the State aid served the citizens of the
State; and
(3)
the alignment of the uses of the State aid with the goals
defined in the Maryland State Plan for Postsecondary Education.
MICUA must submit a report summarizing the information institutions
provide to DoIT by October 1 annually. All reports required by the bill must
contain specified information in a format DoIT requires.
Effective Date:� June 1, 2009
Signed by the Governor on 5/19/2009; Chapter #558
& 558
For more information, please contact:�
Sheila Higdon
Despite
the severe budget shortfall, the legislature was able to maintain the Medicaid
expansion to parents of MCHP children, because of the influx of nearly $1.4
billion in stimulus funds from the federal government.� However, the State has indefinitely placed
the Medicaid expansion to childless adults on hold until the structural deficit
is addressed or revenues rebound.
Only
a few medical malpractice bills were introduced this session and none gained
enough support to be considered in the opposite chamber.
Again
this year the Maryland Trial Lawyers initiated efforts to increase the cap on non-economic damages in medical
malpractice cases but were unsuccessful. Johns Hopkins, in conjunction
with the Maryland Hospital Association (MHA), Medstar, and Anne Arundel Medical
Center, testified against the measure. Despite the bill being sponsored
by 11 of the 12 committee members where the bill was heard, it was never voted
out of committee. Unfortunately, this is an issue that can be expected to
return next year.
Several
bills failed that would have expanded the protections for expressions of regret or apology made by a health care provider
after an adverse medical event in certain health care malpractice
proceedings. The apology bill has been introduced each session for the
past four years and will likely be introduced again next session as well.
The
Task Force on Administrative
Compensation bill introduced again this session was the latest attempt to
create health courts in an effort to remove health care claims from the
traditional court process. The bill died in committee.
Bills
were introduced to increase the amount
in controversy required for jury trial demand in civil cases from $10,000
to $20,000. The bills would have required the passage and ratification of
a constitutional amendment to allow for the change. Neither the bill nor
the constitutional amendment passed.
A
bill eliminating the registration
requirement stipulating that prescribers be authorized by DHMH to prescribe
a controlled dangerous substance in the state was unsuccessful.� Bills to establish an Evidence-Based
Prescriber Education and Outreach Program at DHMH and a bill requiring the
Alcohol and Drug Abuse Administration to assist in the regulation of the sale
of ephedrine, pseudoephedrine, or phenylpropanolamine by establishing and
maintaining a real-time statewide electronic logbook failed under the weight of
budget constraints.�
Please find
details on relevant bills which passed below.
SB0242 �Dispensation of Prescription Medication - Provision of
Information Relating to Incorrectly Filled Prescriptions
SB 242 requires pharmacy permit holders to post
conspicuous signs that include information on the process for resolving
incorrectly filled prescriptions.
Effective Date:� October 1, 2009
Signed by the Governor on 4/14/2009; Chapter #45
For more information, please contact:�
Delora Sanchez
SB0309/HB0252
�State Board of Pharmacy - Pharmacy Permit - Term and
Renewal
SB 309/HB 252 extends the pharmacy permit
renewal term from one year to two years and requires the Board of Pharmacy to
send a renewal notice to each pharmacy permit holder on or before October 1 of
the year the permit expires.
Effective Date:� July 1, 2009
Signed by the Governor on 5/19/2009; Chapter #533
For more information, please contact:�
Delora Sanchez
SB0791/HB0725
�Group Model Health Maintenance Organizations - Drug
Therapy Management
SB0791/HB 725 requires licensed physicians and
pharmacists that provide drug therapy management to patients in a group model
HMO to have physician-pharmacist agreements approved by the State Board of
Pharmacy and State Board of Physicians.�
Drug therapy management must be provided in accordance with the
agreement and through the internal pharmacy operations of the group model
HMO.� The physician-pharmacist agreement
shall prohibit the substitution of a chemically dissimilar drug product by the
pharmacist unless specified in the agreement. A therapy management contract is
not required for the management of patients in an institutional facility or in
a group model HMO.
Effective Date:� October 1, 2009
Signed by the Governor on 5/7/2009; Chapter #314
& 315
For more information, please contact:�
Delora Sanchez
Several
bills were introduced that would have placed salvia divinorum on Schedule I of Maryland’s controlled
dangerous substance list. The proposed legislation had unintended
ramifications for NIH-funded biomedical research being conducted on Salvia D at
the Johns Hopkins University School of Medicine. Johns Hopkins worked
with interested stakeholders in amending the bills to place an age restriction
on Salvia D rather than scheduling it so as to protect current and future
research on the substance in the event that the bills moved forward. The
bill was amended as requested but failed to get to a floor vote on the last day
of session.
When
legislation passed in 2006 to regulate the licensing of polysomnographic
technologists, several issues were inadvertently created that will create
problems for future research and the
clinical practice of polysomnography in the State. When legislation
was introduced this session to extend the deadline for licensure of
polysomnographic technologists, Johns Hopkins supported the legislation,
stressing that the extension is needed in order to correct the current
statute. Johns Hopkins intends to collaborate with the Board of
Physicians during the interim to develop a solution to preserve sleep research
in Maryland.
A
number of bills were introduced this session dealing with genetic information rights, many of them prohibiting the use of
genetic profiling by insurance companies. However, two bills which
defined an individual’s genetic information as their personal property
would have resulted in a requirement for informed consent for use of any human
tissue. With advice from Johns Hopkins’ legal department,
amendments were drafted to exclude research activities from the purview of this
bill. These amendments were accepted by the Senate sponsor. The
Chairman of the Health and Government Operations Committee asked that all of
the genetic privacy bills be withdrawn and be considered in summer study.
We will be involved in the summer study process to ensure that our concerns are
addressed.
This
session, two significant projects supported by Johns Hopkins, the Red Line Project in Baltimore City and
the Corridor City Transitway in
Montgomery County, maintained the planning money needed to move forward toward
possible inclusion in the Governor’s proposals for federal funding which
would be sent to Capitol Hill next year.
Please find
details on relevant bills which passed below.
SB0614/HB0426
�Transportation - Baltimore Corridor Transit Study -
Red Line Area
SB 614/HB 426 prohibits MTA from acquiring
property from 2009 through 2013 for the Red Line transit project if the
acquisition would result in residential displacement.
Effective Date:� October 1, 2009
Signed by the Governor on 5/19/2009; Chapter #569
& 570
For more information, please contact:�
Mat Palmer
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.
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