2015 legislative session outcomes and priority issues jennifer witten, government relations director...
TRANSCRIPT
2015 Legislative Session Outcomes and Priority Issues
Jennifer Witten, Government Relations DirectorModerator
Maryland Hospital AssociationAugust 21, 2015
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Agenda
• Panel Introduction• Panel Discussion
– Political Environment– 2015 Legislative Outcomes – 2016 Priorities
• Audience Questions
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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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.
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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?
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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?
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Audience Questions
Thank You
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