November 17, 2019
Collective Action, Unified Message
The other day we got a preview of the headwinds the hospital field can expect to face when the Maryland General Assembly session opens in seven weeks.

MHA participated in a Senate committee briefing on facility fees. At the briefing, MHA highlighted our field’s proactive effort to improve transparency for patients. Products of the initiative were a consumer fact sheet on facility fees, voluntary uniform disclosure standards for your hospitals, and a letter of commitment for hospitals to sign saying they will adopt the standards. Most of your hospitals already have signed on.

Despite these efforts and our collective work to educate lawmakers, regulators and consumers, it’s apparent from both the public event and our private encounters with legislators that they will be hard to please.

As you know, consumers’ cost exposure—not just facility fees but also surprise bills, debt collection, and more—makes daily headlines and stirs ire from lawmakers in Maryland and nationwide. Much more of that frustration is aimed at hospitals than at the insurers whose narrow networks, restrictive coverage policies, and high deductibles cause that exposure.

On the matter of debt collection—which is linked to financial assistance for patients in need—we expect lawmakers to propose legislation to overhaul hospitals’ practices. MHA, again, is out front. MHA’s Executive Committee last week considered a set of proposed principles that will demonstrate Maryland hospitals’ dedication to fairness and compassion for all patients.

The Executive Committee also addressed yet another threat to hospitals’ ability to deliver essential services: the medical liability crisis. The committee heard that reinsurers that backstop hospitals for the cost of large awards have come to view Maryland as almost toxic—all because the rules are tilted against hospitals. The committee endorsed a muscular legislative strategy to bring some sanity to the rules governing the resolution of malpractice cases. 

Expect to hear more from us on all these topics in the weeks ahead. To succeed in the legislative session, we will need collective action and a unified message.
Bob Atlas
President & CEO
HSCRC Approves Regional Partnership Program, MPA Policy
At their November meeting Wednesday, HSCRC commissioners approved staff’s final recommendations to update the Regional Partnership program. The changes renew funding and require partnerships to focus on three statewide population health priorities: Diabetes prevention and management programs, behavioral health crisis programs and population health priority area #3, to be identified by December 2020. They also approved the rate year 2022 Medicare Performance Adjustment Policy. Read more in this month’s issue of Newsbreak .
MHA Participates in Facility Fee Briefing
On Tuesday the Senate Finance Committee and members of the House Health and Operations Committee held a briefing on hospital outpatient facility fees. MHA participated in the briefing alongside representatives from the Attorney General's Health Education & Advocacy Unit (HEAU) and the Health Services Cost Review Commission (HSCRC) . MHA shared our work with members over the interim to develop a process for uniform facility fee disclosure, which most members have already signed on to. While members appreciated the effort of the field, questions were raised regarding the necessity of facility fees and overall concerns regarding consumer cost exposure. MHA will continue to work with members of the legislature, HSCRC and HEAU to influence the potential introduction of legislation. Questions about the briefing should be directed to Jennifer Witten .
MHA Comments on HSCRC’s Proposed Capital Financing Policy
In a letter to HSCRC November 6, MHA commented on HSCRC’s proposed capital financing policy . In the letter, MHA said the project cost threshold in the proposal, coupled with the efficiency measure, is too restrictive. MHA also said that capital funding should be considered in the annual payment update, but not automatically subtracted from the inflation portion of the update factor.
Maryland State Budget Outlook Updates
The General Assembly’s Spending Affordability Committee received its annual fall briefing last week from the Department of Legislative Services (DLS) on the state’s budget landscape. The Spending Affordability Committee recommends spending levels to the Governor and the General Assembly for the upcoming session (the state’s fiscal year 2021 budget). While the state’s fiscal year 2021 budget outlook is better than it was earlier this year, challenges lie ahead with a continued projected shortfall, which is projected to be over $1 billion by fiscal year 2022. It is expected to be a difficult budget year given this shortfall and a number of competing priorities, including the Kirwan Commission. The Kirwan funding formula recommendations, which will be passed in some form this session, will put significant pressure on the state and local budgets through fiscal year 2030. The Spending Affordability Committee will be making their final recommendations in December. For questions, contact Brian Frazee .
MHA to Host General Assembly Communication Overview
Government affairs and public relations leads are invited to attend a joint meeting hosted by MHA. The meeting will focus on the 2020 session of the Maryland General Assembly and hot-button topics likely to be discussed. A representative from every hospital is encouraged to attend to help bolster MHA’s lobbying efforts in support of a proactive communications strategy for these complex issues. For questions, contact Jane Krienke .
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