2015 Legislative Session Outcomes
and Priority Issues
Jennifer Witten, Government Relations Director
Moderator
Maryland Hospital Association
August 21, 2015
Agenda
• Panel Introduction
• Panel Discussion
– Political Environment
– 2015 Legislative Outcomes
– 2016 Priorities
• Audience Questions
1
Panel
• Delegate Nicholaus R. Kipke-District 31B, Anne Arundel
County
• Senator Delores G. Kelley-District 10, Baltimore County
• Senator Catherine Pugh-District 40, Baltimore City
• Pegeen Townsend-VP of Government Affairs, MedStar
Health
• Nicole McCann-Director of Health Policy for Johns
Hopkins State Affairs
2
New Players
• Governor Hogan
• Key health care personnel
– Van Mitchell, Secretary, DHMH
• Former legislator; health lobbyist
– Bobby Neall, Fiscal Advisor
• Former legislator; CEO Priority Partners
– Al Redmer, MD Insurance Comm
• Former legislator; Coventry Health Care
– Craig Williams, Chief of Staff
• Govt’ Affairs Amgen
• 70+ new legislators
3
Session Challenges
• Many new players
– Administration
– Legislature
• Key committee member changes
• Education
– Basics – Medicare vs. Medicaid
– Complex health care issues – waiver
• Significant budget debate
– Eliminate state structural deficit; reduce taxes
4
State Budget-Healthcare Impact
• Health Care – all Medicaid provider payments cut
• Physicians
– Medicaid fees cut from 100% to 92% Medicare rate
• Nursing Homes
– Medicaid payments cut to 2014 levels
• Pharmacists
– Medicaid dispensing fees cut
• Managed Care Organizations
– 2% rate cut
5
State Budget
• Hospital Impact
• $16.7 million cut for 2016
• Original proposal would have effect of greater financial
impact across-the-board rate cut for all payers
• Secured fix to implement differently, more efficiently
resulting in greater savings
• Secured ability to “count” toward total savings pending
HSCRC action to cut uncompensated care funds
6
Hospital Legislative Priorities
• Reduce, eliminate Medicaid hospital tax
• Restrain out-of-control liability costs
• Improve care for people suffering from mental health,
substance abuse problems
7
Medicaid Hospital Tax
• Began in 2009 as a “temporary” $19 million tax to backfill
state’s Medicaid budget – has ballooned to nearly $400 million
annually
• Inflates hospital bills by 3% - revenue goes to state special
Medicaid fund, not hospitals
• Makes meeting new waiver spending targets more difficult
• Maryland has an opportunity to reduce tax burden on patients
and their families
8
Outcome: Medicaid Hospital Tax
• State budget now includes a $25 million hospital tax “spend
down” each year
• Supported by Governor, Budget Secretary Brinkley and
legislature
• Opportunity to seek an increase in the spend down amount as
state budget improves
9
10
Restrain High Liability Costs
• Progress:
• No-fault birth injury compensation fund
• Held: Committee of legislators to address over interim; excellent step toward new
bill next year
• Access to obstetrical services
• Passed: MHA to lead study; connect to need for no-fault birth injury fund
• Health Courts
• Interim study
• Blocked:
– Tripling of cap on non-economic damages from $750,000 to $2.4
million
11
12
Joint Committee on Behavioral Health and
Opioid Use Disorder (HB896/SB607)
– Built broad-based coalition of support
– Incorporated with other behavioral health bills to create one
effort to address issues
– Committee of 10 legislators will address over 6 years
– Hogan administration interest – connection to heroin
initiative
– First briefing Sept 9, HGO
13
Maryland Emergency Department Opioid
Prescribing Guidelines
• MHA took the lead in drafting standardized opioid prescribing guidelines
for hospital emergency departments based on current crisis.
• The guidelines are informed by the work of the Massachusetts Hospital
Association, as well as a patient-focused brochure developed by the
Maryland Chapter of the American College of Emergency Physicians
(MDACEP) and released in 2014.
• The Maryland Heroin and Opioid Emergency Task Force will release its
comprehensive plan to address the state’s heroin/opioid misuse epidemic
this fall and MHA’s guidelines will be included in those recommendations.
14
Additional Legislation-Policy Issues
• (SB297-Ch.155) Task Force on Family Caregiving and Long-Term
Supports
• (HB1101) Department of Health and Mental Hygiene-Health Program
Integrity and Recovery Activities
• (HB05-Ch.56) Department of Health and Mental Hygiene - Newborn
Screening Program Fund
• (SB606-Ch.372) Health Insurance - Abuse-Deterrent Opioid Analgesic
Drug Products - Coverage
• Telehealth
• Medicaid Redetermination
• Other issues?
15
2016 Legislative Outlook
• What priority issues will each of you focus on for
2016
• What efforts over the interim will move issues
forward?
• What might be introduced or reintroduced in the next
legislative session?
16
Audience Questions
Thank You
17