Articles

2003 Health Care Legislative Update - Part 2: Highlights of the 2003 Legislative Session

• Health Occupations – Maryland Optometry Act – Replacement Contact Lenses – Clarifications and Modifications (SB 387) (10/01/03)

Prohibits a person from knowingly selling or dispensing contact lenses or replacement contact lenses without a valid and unexpired prescription or replacement contact lens prescription. A person who violates any provision shall be guilty of a misdemeanor and, on conviction, subject to a fine not exceeding $1,000.

• Health Occupations – Dentists and Dental Hygienists – Licensure – Examination Required (HB 334) (10/01/03)

In order to be granted licensure in Maryland, a dentist who is licensed in another state and who has passed a regional board is required to pass a comprehensive examination on applied clinical diagnosis and treatment planning as well as a law examination. A dentist who has not passed a regional board, in addition to the passing the required examinations, must have been actively engaged in the practice of dentistry for the preceding five years. Similarly, a dental hygienist who has passed a regional board is required to pass an examination given by or designated by the Board. A dental hygienist who has not passed a regional board is, in addition to passing the examination, also required to have been actively engaged as a dental hygienist for the preceding three years.

• Health Care Facilities and Regulation – Nursing Facilities – Maryland Medical Assistance Program – Payment for Reserved Beds (HB 1009) (07/01/02)

Alters the time period requirement governing a leave of absence from a nursing facility (not to exceed a total of 18 days for a 12-month period). Also, requires the Department of Health and Mental Hygiene to make a specified payment to a nursing facility for each day that a resident is hospitalized and a bed is reserved and made available for the resident’s return. Also provides that a payment from the Department to a nursing facility for a reserved bed may not include payment for nursing services. The Act applies retroactively to July 1, 2002, making the Act an emergency measure.

• Health Care Facilities and Regulation – Maryland Health Care Commission – Hospice Care (SB 732) (10/01/03)

Prohibits the Maryland Health Care Commission from granting a person that operates a hospice care program a statewide certificate of need or authority to operate the hospice care program statewide through a Commission ruling or determination. A person who acquired or purchased a general hospice care program and who was authorized by the Commission to operate the program on a statewide basis prior to March 1, 2003, may only serve residents of any jurisdiction in which services were provided on or before December 1, 2001.

• Health Occupations – State Board of Podiatric Medical Examiners – Revisions – Licensure and Penalties (HB 257) (10/01/03)

Requires the members of the State Board of Podiatric Medical Examiners to have significant peer review experience as a qualification for membership; requires that an applicant for licensure who has practiced in another state to submit proof of practice that is sufficient to demonstrate current clinical proficiency; requires a licensee to obtain renewal status after a grace period of 30 days following the expiration of the license; and alters the circumstances under which the Board may issue a license to an individual on inactive status.

• Health Insurance – Medicare Supplement Contracts – Availability (HB 498) (07/01/03)

Requires insurance carriers that provide Medicare supplemental contracts to make available both a Medicare supplement policy Plan C and a Medicare supplement policy Plan I to individuals who are under the age of 65 but who are eligible for Medicare due to a disability during the 6-month period following the applicant’s enrollment in Part B of Medicare.

• Health Occupations – Pharmacists – Practice – Information on Generic Drug Option (HB 684) (10/01/03)

Requires a pharmacist to inform retail consumers of generically equivalent drugs; and requires a pharmacist to inform retail consumers of the approximate cost difference of generically equivalent drugs as compared to brand name drugs.

• Health Insurance – Behavioral Health Care Services – Reports (HB 729) (10/01/03)

Requires carriers that own or contract with managed behavioral health care organizations to include information on behavioral health care providers in lists of providers on the carrier’s provider panel. Also requires a carrier that contracts with a managed behavioral health care organization to require that organization to provide a report on direct behavioral health care expenses that the carrier is required to make publicly available.

• Health Insurance – Reimbursement for Provider Services – Professional Counselors and Therapists (HB 894) (10/01/03)

Requires reimbursement for services of professional counselors, marriage and family therapists, or alcohol and drug counselors under an individual, group, or blanket health insurance policy, contract, or certificate of an insurer or nonprofit health service plan that is delivered or issued for delivery in the State; is issued to a group that is incorporated or has a main office in the state; or covers individuals who reside or work in the State and is issued, renewed, amended, or reissued on or after October 1, 2003.

• Health Insurance Coverage Availability Act of 2003 (HB 1100) (04/08/03)

Makes health insurance coverage available to medically uninsurable individuals who lose coverage through the Maryland Health Insurance Plan (“the Plan”). The Plan is an independent unit within the Administration whose purpose is to decrease uncompensated care costs by providing access to affordable, comprehensive health benefits for medically uninsurable residents of the State by July 1, 2003. The Plan will be administered by the Board of Directors for the Maryland Health Insurance Plan. The Board will consist of the following seven members: the Commissioner; the Executive Director of the Maryland Health Care Commission; the Executive Director of the Health Services Cost Review Commission; the Secretary of the Department of Budget and Management; one member to be appointed by the Director of Health, Education, and Advocacy Unit of the Office of the Attorney General; one member to be appointed by the Commissioner to represent carriers operating in the State; and one member to be appointed by the Commissioner to represent insurance producers selling insurance in the State.

• Health Insurance – Nonprofit Health Service Plans – Reform (SB 772) (06/1/03)

Alters the provisions relating to the regulation of nonprofit health service plans; establishes the mission of nonprofit health service plans; establishes a Joint Nonprofit Health Service Plan Oversight Committee; prohibits the acquisition of a specified nonprofit health service plan for five years after the effective date of the Act. Specifically, this Bill:

• Ratifies the Insurance Commissioner’s decision and declares that it is in the interest of all Marylanders to protect and preserve CareFirst in its nonprofit form;
• Codifies the mission of any nonprofit health service plan and prohibits the acquisition or conversion of the company for five years;
• Requires the removal and replacement of ten members of the Board by December 1, 2003, and the remaining two board members in 2004 selected by a nominating committee appointed by the Governor, Senate President, and Speaker;
• Adds two non-voting members to the Board, one each appointed by the Speaker and the President;
• Limits Board compensation to $12,000 per member; $15,000 for the chairman and committee chairs;
• Requires Board approval for actions related to significant modification of benefit levels, provider networks, provider reimbursement, underwriting guidelines, rates or rating policies, withdrawal of a product, or withdrawal from a line or type of business or geographic region;
• Specifies that a director, trustee, officer, executive, or employee of the company may only approve or receive fair and reasonable compensation and subjects current compensation arrangements to this standard;
• Requires the board to develop, and submit for Insurance Commissioner approval, guidelines on compensation of officers and executives that is reasonable in comparison to similar nonprofit health service plans;
• Requires annual review of compensation paid to officers and executives to determine if the compensation is in compliance with the approved guidelines;
• Increases from $5,000 to $10,000 the penalty for officers, directors, or employees of the company who misrepresent or conceal a material fact to the Board or to the Insurance Commissioner or misappropriate corporate money;
• Establishes a 17-member Joint Nonprofit Health Service Plan Oversight Committee (two year sunset), to examine and evaluate the ability of CareFirst to meet the statutory nonprofit mission.
• Requires CareFirst to work with the Insurance Administration, the Depart-ment of Aging, and other appropriate entities to study and, if feasible and desirable, develop a state arrangement to offer coverage to the Bethlehem Steel retirees between 55 and 64 years of age;
• Requires the Insurance Commissioner and the Attorney General to determine whether any of the conduct identified in the order related to the conversion violated any laws;
• Provides the Attorney General with specific statutory authority to investigate whether nonprofit health service plans are engaging in unsafe or unsound business practices if the Insurance Commissioner fails to take action; and,
• Authorizes CareFirst, as a nonprofit health service plan, to access capital via the Maryland Health and Higher Educational Facilities Authority (“MHHEFA”) and the Maryland Economic Development Corporation.
• Public Health – Hospitals – HIV Testing – Health Care Providers (HB 343) (07/01/03)

In instances where a health care provider has been exposed to HIV, has given prompt notice of exposure but due to the physical or mental condition of the patient is unable to obtain the patient’s informed consent to conduct HIV tests, the hospital infectious disease/communicable disease officers are permitted to order tests to be conducted on blood samples or other body fluids of hospital patients for the presence of antibodies to the human immunodeficiency virus (HIV).

• Public Health – Elderly – Money Follows the Individual Act (HB 478) (07/01/03)

Prohibits the Department of Health and Mental Hygiene from denying an individual access to a home- and community-based services waiver for services due to lack of funding for such services if the individual is living in a nursing home at the time of the application; the nursing home services were paid by the program for at least 30 consecutive days immediately prior to the application; the individual meets all of the eligibility criteria for the waiver; and the services provided would qualify for Federal matching funds. Nothing in the Act is intended to result in a reduction in Federal funds.

• Public Health – Maryland Pharmacy Access Hotline (SB 676) (10/01/03)

Requires the Department of Health and Mental Hygiene to use existing resources to establish a toll-free Maryland Pharmacy Access Hotline that operates during regular business hours and during non-business hours allows callers to leave a message.

• Public Health – Maternal Mortality Review Program – Termination Provision – Repeal (SB 688) (06/01/03)

Repeals the termination provision of the Maternal Mortality Review Program.

• Public Health – Disease Prevention – Hepatitis C Advisory Council (HB 386) (10/01/03)

Establishes a State Advisory Council on Hepatitis C to provide advice and recommendations to the General Assembly on public awareness, education, screening, and treatment related to hepatitis C. The Council shall consist of 16 members one of whom shall be a member of the Senate of Maryland appointed by the President of the Senate; one shall be a member of the House of Delegates appointed by the Speaker of the House; one shall be the Secretary of Health and Mental Hygiene or designee; one shall be the Secretary of Veterans Affairs or designee; one shall be the Secretary of Public Safety and Correctional Services or designee; and eleven shall be appointed by the Governor. Of those appointed by the Governor, one shall be an internist; one shall be a hematologist; one shall be a hepatologist; one shall be a clinical researcher specializing in diseases of the liver; one shall be a member of the public; one shall be a Veteran of the Armed Forces who has Hepatitis C; two shall be members of the pharmaceuticals industry; one shall be a nurse practitioner; one shall be a representative of the American Liver Foundation; one shall be a representative of the Baltimore City Health Department. Council member terms shall be for two years; however, members shall continue to serve until a successor is named.

• Public Health – Task Force on the Needs of Persons with Co-Occurring Mental Health and Substance Abuse Disorders (HB 433) (10/01/03)

Establishes a Task Force on the Needs of Persons with Co-Occurring Mental Health and Substance Abuse Disorders; providing for the composition of the Task Force. The Task Force shall consist of the following members appointed by the Governor: one representative of the Alcohol and Drug Abuse Administration; one representative of the Department of Human Resources; one social worker from the Department of Social Services; one representative of the Department of Rehabilitative Services; one representative of the AIDS Administration; one representative of the Department of Juvenile Justice; one representative of the Faith-Based Community Providers; one representative of the Department of Housing and Community Development; one representative of the Department of Public Safety and Correctional Services; one State court judge; one representative of the State’s Attorney’s Office; one representative of the Public Defender’s Office; one representative who is a consumer of co-occurring disorder services or who has a family member who uses such services; one representative of the Co-Occurring Disorders Workgroup of the National Council on Alcoholism and Drug Dependence, Inc; one representative of the Maryland Psychiatric Society; one representative from the Maryland Nurses Association; one representative from the Maryland Hospital Association; one representative from the Community Behavioral Health Association of Maryland; one representative from the Maryland Legislative Council of Social Workers; one representative from the Maryland Psychological Association; one representative from the State’s Public Academic Health Center; and two consumers. Members are prohibited from receiving compensation but are entitled to reimbursement of expenses.

• Baltimore City Health Department – Designation of Nonprofit and Quasi-Governmental Entities by Local Health Departments (HB 465) (10/01/03)

Authorizes the Baltimore City Health Department to designate nonprofit and quasi-governmental entities to receive funds from the Alcohol and Drug Abuse Administration; authorizes a local health department to revoke a designation except to the extent that the Administration, the designee, or both have acted in reliance on the designation. Requires the Administration to disburse funds directly to designated nonprofit or quasi-governmental entities; provides that the Administration shall have the same rights and remedies with designated nonprofit or quasi-governmental entities as it would with the Baltimore City Health Department.

• Consumer Protection – Maryland Consumer Protection Act – Private Right of Action (SB 283) (07/01/03)

Specifically prohibits private medical liability actions from being brought under the Maryland Consumer Protection Act to close a loophole being used by plaintiffs’ attorneys to circumvent Maryland’s cap on noneconomic damages.

• Maryland Health Insurance Plan (MHIP) and Senior Prescription Drug Program – Modifications and Clarifications (HB 803) (04/08/03)

Repeals the provision requiring the Health Services Cost Review Commission (“HSCRC”) to determine and collect funds necessary to operate and administer MHIP. Instead, HSCRC is charged with simply calculating the amount of funds necessary and the MHIP Board must collect the assessment made against hospitals in order to operate and administer MHIP. Permits the MHIP Board to allow the fund administrator to collect premiums from both MHIP and Senior Prescription Drug Program enrollees, deposit premiums in a separate account titled in the name of the State, and pay claims for enrollees from the account. If excess funds are collected, the administrator must deposit the balance, including any interest earned, into the MHIP fund by the 15th of the following month. The Bill also clarifies the amount CareFirst must deposit in the fund for the program may not exceed the value of its premium tax exemption for the previous calendar year. Also permits the Board, if it determines that a standard risk rate would create market dislocation, to adjust the premium rate based on member age rather than the current basis of family composition.

• Vera’s Law (HB 149) (07/01/03)

Requires the Department of Health and Mental Hygiene to develop guidelines for a nursing home that elects to use electronic monitoring with the consent of a resident or the legal representative of the resident.

• Mental Hygiene Administration – Emergency Evaluation – Standards and Content (HB 668) (10/01/03)

Repeals the requirement that a petition for emergency evaluation of an individual with a mental disorder be based on whether the petitioner believes there is a “clear and imminent” danger of the individual doing bodily harm to themselves or others. The new standard is whether the petitioner believes the individual presents a danger to the “life or safety” of themselves or others. The Bill also broadens what information a health professional or peace officer can base the petition on by adding any information that is pertinent to the factors giving rise to the petition.

• Maryland Medbank Program – Administration, Extension and Funding (SB 334) (07/01/03 and other dates)

Extends the Medbank program until June 30, 2006, and transfers administration of the program from the Maryland Health Care Foundation to Medbank of Maryland, Inc. Medbank will be the central coordinating office for the state and must ensure the program is available to residents throughout the state. The program will be funded entirely by the Department of Health and Mental Hygiene; for FY’2004, funding will come from transferring money from the MCO incentive fund.

• Maryland Medical Assistance Program – Reimbursement for Outpatient Mental Health Treatment – Dual Eligibility (SB 209) (07/01/03)

Requires the Department to reimburse community-based outpatient mental health care providers the full amount of the program fee for patients who are dually eligible for both Medicaid and Medicare. The initiative is to be funded through existing resources by reprioritizing existing grant funds.

• Medicaid Modernization Act of 2003 (HB 762) (07/01/03)

Establishes a Primary Adult Care Network within Medicaid to provide a primary and preventive health care benefits package to indigent and medically indigent adults. The purpose of the network is to consolidate health care programs and services currently available to adults and access federal funding to expand primary and preventive care to adults lacking health care services.