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June 28, 2020
MHA will not publish Toward Better Health July 5. The newsletter will be back in your inboxes July 12.
Spotlight on Hospital Prices
The Centers for Medicare & Medicaid Services (CMS) can require hospitals nationwide to publicly share charges they negotiate with payers, a federal court ruled Tuesday.

The field has prepared for this rule since last year, yet we’d hoped this burdensome mandate would be scrapped through a challenge from health care groups, including the American Hospital Association.

In other states lacking rate setting, this means five types of charges must be shared publicly, including gross charges and those negotiated with payers. In Maryland, the rule means hospitals must post standard charges in a searchable form. Also to be posted are prices for “shoppable services,” or those that can be scheduled in advance. All by January 1, 2121.

MHA is here to help you comply. We’ll take up this matter with our Technical Work Group to offer fieldwide guidance.

We also foresee deeper scrutiny of hospital costs in the wake of the COVID-19 crisis. Our advocacy on consumer cost exposure has been ongoing for some time. We have aimed to educate policymakers on your commitment both to affordability for patients and to preservation of a stable health system.

Maryland hospitals have long been pioneers in transparency, so patients have access to useful and accurate information about costs and quality. There already are multiple places in our state where consumers can obtain information about health costs—the Health Services Cost Review Commission, Maryland Health Care Commission, and your own hospitals.

We’ll keep you updated on the work of our member-led groups, to make sure transparency guidance makes sense for hospitals and gives patients practical information to make decisions about their care.
Bob Atlas
President & CEO
Gov. Hogan Thanks Hospital Heroes
Gov. Larry Hogan shared a video message of thanks Saturday for Maryland’s health care heroes, including the dedicated caregivers in hospitals who are on the front lines of the fight against COVID-19. In the video , he says, that during this public health crisis, caregivers in Maryland's hospitals have "proven themselves to not just be essential workers, but front line heroes. The challenges these heroes have faced are immense, unprecedented, and truly inspiring."
QBR Policy Updates on Hold 
The Health Services Cost Review Commission (HSCRC) dropped plans to update its Quality Based Reimbursement (QBR) policy in light of hospitals’ ongoing efforts to respond to COVID-19. They had planned to consider revisions to how patient experience measures (HCAHPS) are handled in the policy. In late fall, they plan to convene the Performance Measurement Work Group and will vet updates to the policy at that time. HSCRC may take up more comprehensive changes to its QBR policy next year with a dedicated subgroup.
$1.45B in Cuts Proposed for State Budget
The Board of Public Works (BPW) will hear a proposal July1 to reduce the fiscal year 2021 state budget by $672 million. Gov. Larry Hogan’s administration also proposes additional actions that would make the total fiscal year 2021 cuts about $1.45 billion. Several key budget items are of interest to hospitals.
 
  • Increase the Medicaid Deficit Assessment by $35 million
  • Take $5 million from the Board of Physicians’ fund balance
  • Eliminate the 4% Medicaid provider rate increases
  • Hold the out-of-home provider rates at the FY 2020 level
 
MHA will draft a letter to the Board of Public Works about the negative impact these cuts would have on health care in Maryland, which we will share with the field.
New Laws in Effect
After passing the state legislature in March, many new laws take effect July 1. One law extends the timeframe for reimbursement of evidence collected from a sexual assault forensic exam and provides privacy protections for patients by limiting the information required for reimbursement. MHA advocated for this legislation in partnership with members of the Maryland Attorney General’s Sexual Assault Evidence Kit Policy and Funding Committee. Many of the laws establish stakeholder work groups, which MHA will be engaged with during the interim, including a Department of Health work group focused on developing recommendations for improving the Maryland Loan Assistance Repayment Program and a work group led by the Health Services Cost Review Commission, tasked with determining requirements for community benefit reporting.
Senate Briefing on the Impact of COVID-19 on Vulnerable Populations
On Thursday, the Senate Health and Human Services subcommittee held a briefing on the impact of the pandemic on vulnerable populations. Legislators from the Senate Finance committee, including Chair Delores Kelley, were also in attendance. Several state agencies presented, including the Maryland Department of Health (MDH) and Department of Human Services. Tricia Roddy, acting Medicaid Director, described the regulatory relief obtained during the pandemic including telehealth flexibilities. Ms. Roddy said Medicaid is evaluating which services would be appropriate for delivery of telehealth in a patient’s home on a permanent basis. Senators raised questions about broadband access, privacy protections, and payment as the state modifies telehealth regulations.

MDH fielded questions about potential uses for the state’s flexible CARES Act funding. The Community Health Resources Commission (CHRC) described their federally-funded COVID Emergency Funding Relief grants. CHRC awarded $1.3 million in funding to 45 applicants. Community providers were also invited to share stories of their experiences during the pandemic and recommended changes to address barriers and issues they encountered.
Hospital Bond Program Applications Due July 2 
The deadline to submit applications for the 2020 MHA Hospital Bond Program is July 2. Application forms and supporting documentation are available on MHA's SharePoint site . Completed applications must be submitted via the hospital-specific SharePoint site. For questions, please contact Brett McCone Jennifer Witten , or  Jane Krienke .
Trauma Series Supports Health Care Workers During COVID-19
The Horizon Foundation will host a free, virtual trauma series July 8. The series, Coping with Trauma on the Frontlines of COVID-19 , is aimed at supporting essential workers facing the unique mental challenges of the COVID-19 crisis. It will include personal reflections from trauma survivors and tips from mental health professionals on how to process trauma. Registration is open now .
Md. Behavioral Health Administration Shares Resource Guide
The Maryland Department of Health (MDH) Behavioral Health Administration (BHA) developed a resource guide for individuals and behavioral health providers to access local and national resources addressing intimate partner violence (IPV), traumatic brain injury (TBI), and child maltreatment. 
National Health Service Corps New Site Application is Open
The National Health Service Corps (NHSC) is accepting applications to approve new health care facilities in their network. By becoming an NHSC-approved site, eligible clinicians at your health care facility can apply for an NHSC loan repayment award. You can also recruit NHSC scholarship recipients to work for you. The application cycle closes July 21.
The Daily Record Health Care Heroes
On Thursday The Daily Record celebrated its 2020 Health Care Heroes in a virtual event. Congratulations to all of the MHA members who were included in the list, including a new category for COVID-19 Heroes. MHA is proud to have been the Event Partner for this important recognition. Nominations are now open for next year’s event.
Maryland Hospital Inpatients
Date
Total No. of Inpatients*
Percent of COVID Inpatients
April 2
4,800
9%
May 5
6,300
27%
June 24
6,700
8%
Source: CRISP – MIEMSS Facility Resources Emergency Database (FRED) Hospital Capacity Dashboard
*Adult and pediatric med/surg and ICU beds
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