March 24, 2017
Patients, Not Politics, Come First
Seven years ago, hospitals across the country came together to support the Affordable Care Act - a sweeping and untested yet hugely promising national experiment to expand health care coverage to millions of Americans. Hospitals' support came not from political ideology, but from prioritizing patients. At a fundamental level, more people with access to health care services means that hospitals are better equipped to meet their mission of care.
Now, as the push in Congress to repeal and replace the ACA evolves (even by the minute today), hospitals remain committed to the principle that broad-based coverage is the foundation of efficient, high-quality health care. That's why hospitals across the nation oppose the American Health Care Act as it is written.
Health care reform brought an additional 450,000 Marylanders over the past five years access to the care they need. But the proposed AHCA is expected to result in hundreds of thousands of Marylanders losing health care coverage. Some will choose not to have insurance, as the financial penalties for not having coverage would be removed. Others simply won't be able to afford insurance as subsidies to defray the costs would be repealed. And up to 180,000 of our most vulnerable, low-income residents on Medicaid could lose coverage entirely.
And the proposal drives up the cost of health care for everyone in Maryland. Hospitals' uncompensated care dropped by $350 million as a result of the coverage gained under the Affordable Care Act. As Marylanders lose their health coverage, the cost of uncompensated care gets passed on to everyone in the form of higher health care costs and higher insurance premiums.
Maryland's hospitals know well the value of broad-based coverage, as it has been a key component of the progress that's been made in controlling costs and improving quality under the All-Payer Model. Without coverage, hospitals will be impaired in their work to direct Marylanders to the right care, at the right time, and in the right setting. Once again, hospital emergency departments could become the only source of routine, but very expensive, care for many more Marylanders.
There is tremendous potential if the improvements under the All-Payer Model are allowed to continue, and tremendous danger for Maryland's hospitals if the foundation of this progress - broad-based coverage - is swept away.
The outcome of today's proceedings, if there is one, will do little to quell the national health care debate. That's why hospitals will continue to urge Congress to put forth a proposal that protects patients and preserves coverage, just as they did seven years ago.

Spotlighting Some of the 100+ Bills MHA is Tracking This Session

Maryland Health Care Regulatory Reform Act of 2017 (SB 1020)
This week, MHA testified in opposition to Senate Bill 1020 before the Senate Finance Committee. This bill proposes to merge the Maryland Health Care Commission with the Health Services Cost Review Commission. In her testimony, MHA President & CEO Carmela Coyle welcomed a discussion about developing a more efficient health care regulatory model for Maryland, while stressing the need to be cautious with the timing of such an approach, since Maryland is in the midst of negotiations with the Centers for Medicare & Medicaid Services on the All-Payer Model.

Community Benefit Report - Disclosure of Tax Exemptions (SB 623/HB 921)
Last week, the Senate Finance Committee voted overwhelmingly to give an unfavorable report to Senate Bill 623, which would require hospitals to include the value of their tax exemptions on their annual community benefit reports to the HSCRC. Earlier this session, MHA was invited to brief the House Health & Government Operations Committee on this issue. For the second year in a row, this bill was killed in the Finance Committee and will not advance in the House of Delegates. MHA continues to educate policymakers on the significant concerns with this legislation that is being pursued by SEIU.
At Work in Annapolis
There are less than three weeks left in the legislative session, which adjourns April 10. On Saturday, a bill that would remove critical physician self-referral safeguards by exempting certain oncology centers, passed the House of Delegates and is now in the Senate. MHA, along with hospital leaders, will be testifying in opposition at the Senate hearing in April. The House and Senate both passed their respective versions of the budget and a conference committee will now be appointed to reconcile the differences. Your MHA team is working to secure a spend-down of the Medicaid hospital tax in the state's fiscal year 2018 budget. Links to bills and our position papers can be found in this week's Advocacy Dashboard.
Bond Program Applications Begin Next Week
MHA will host a webinar to provide an overview of the 2017 Hospital Bond Program, which opens March 30, on Tuesday, April 4 at 9 a.m. Click here for more details and to register. This program provides an opportunity to apply for state funding to complete private capital projects. Projects should be well-developed and ready to begin by the beginning of the grant year, June 1, 2018. Hospitals should request correspondence for Certificate of Need non-coverage determination from HSCRC and the Maryland Health Care Commission by Friday, April 28. Applications must be submitted by Friday, June 16, including HSCRC and MHCC correspondence and other letters of support. Application materials will be available starting March 30 on our website at Please note the updates to the project selection scoring guidelines and other application materials. Application forms and other supporting documentation are submitted via hospital-specific SharePoint site. If you have questions, please contact Brett McCone, Jennifer Witten, or Jane Krienke.
Quarterly Financial, Utilization Reports Available
The financial reports for the fourth quarter of 2016 are now available for MHA members. To access the Accounts Receivable and Combined Financial Trends and Utilization reports, click here. Reports are available only to members.
Contact: Brian Sims
ED Leaders Encouraged to Attend Opioid Crisis Meeting
MHA and Maryland's Deputy Secretary for Public Health, Dr. Howard Haft, are hosting a meeting of emergency department leaders to discuss the state's opioid crisis, specifically hospitals' role in dispensing of Naloxone to high-risk patients and those who are accompanying patients. The meeting is March 29, from 7:30 a.m. to 9 a.m. at MHA. We ask that a representative of every hospital attend this important meeting. Due to room constraints, hospitals will be limited to sending only one representative, therefore registration is required. Registration information is here .
Contact: Nicole Stallings
CEOs Invited to Cybersecurity Session
Maryland's hospital CEOs are invited to an American Hospital Association cybersecurity leadership session April 6in Washington, D.C. An AHA-members-only link to the registration page for the session can be found on AHA's special cybersecurity webpage. Leadership Matters: Managing Cybersecurity Risk in Health Care will be held at theLoews Madison Hotel at 1177 Fifteenth Street NW from 7 a.m. to 4 p.m. The session is tailored for hospital or health system presidents/CEOs in response to requests from AHA members for non-technical resources to help them understand and respond to increasing cybersecurity threats. While it is required that the president/CEO of the hospital or health system attend, he or she may be accompanied by the organization's designated cybersecurity lead. The focus of the session will be best-practice leadership to address an organization's risk and minimize the impacts of cyber-events. Registration is free; participants will cover their travel and lodging expenses (the rate at the Loews Madison Hotel is $339 per night). Registrations are accepted on a first-come, first-served basis, and is capped at 20 organizations. The program will feature experts from BDO Consulting USA, including John Riggi, former FBI special agent and Section Chief for Cyber Division Outreach, and AHA staff experts on cybersecurity policy. It also will allow attendees to meet with local law-enforcement officials who are focused on cyber-attack response. For more information, contact AHA's Assistant General Counsel Lawrence Hughes at, or 202-626-2346. 
Cyber Security Resources Available
In an effort to keep hospitals informed of significant threats and vulnerabilities that may affect them, the American Hospital Association is working with the Federal Bureau of Investigation and other federal agencies to share important cybersecurity intelligence. The FBI has asked AHA to share the document Cyber Criminals Targeting FTP Servers to Compromise Protected Health Information, which AHA members can access by logging in to the AHA cybersecurity webpage. For additional AHA resources on cybersecurity, visit Questions should be directed to AHA Assistant General Counsel Lawrence Hughes at or (202) 626-2346, or AHA Vice President of Policy Chantal Worzala at or (202) 626-2313.
The Need to Build Resilience Among Staff
Dr. Bryan Sexton of Duke University cites research that indicates:  50 percent of critical care nurses are emotionally exhausted;  1 out of 4 critical care nurses are clinically depressed; and  30 - 40 percent of all physicians experience burnout, more so than any other U.S. worker.

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Illinois Supreme Court Voids Adverse Hospital Tax Exemption Decision
The Illinois Supreme Court this week vacated an appellate court decision that declared the state's property tax exemption standard for hospitals unconstitutional, concluding that the appellate court did not have jurisdiction to take the appeal. 

Tuesday, March 28
Maryland Healthcare Education Institute Board meeting

Wednesday, March 29
Carmela Coyle presents to LifeBridge Leadership Academy
Maryland Reporter, By Dan Menefee, March 19
ABC 2 News, By Mallory Sofastaii, March
CBS Baltimore, By Associated Press, March 20
The Washington Post, By Brian Witte, March 20
The Baltimore Sun, By Ian Duncan, March 21
WBAL-TV, By Kate Amara, March 20
Your 4 State, March 22