Barbara Marx Brocato & Associates
The Recession Session
~ Monday, April 13, 2009 ~
As the 2009 Legislative Session of the Maryland General Assembly adjourned at midnight, worry over the fiscal health of the State continues.
The Governor and Legislature enacted a number of budget cuts, maneuvered funds from various accounts and plugged in Federal Stimulus Funds to achieve a balanced budget for FY2010. What has not been resolved this year is the projected shortfalls in future budgets (an estimated $1 billion shortfall in FY2011). There will be continuing discussions in the coming months over revenue streams, shifting financial responsibilities (burdens), and potential for more cuts to services and State agencies.
This session's work included an extensive look at the State's Medevac system. A tragic crash of one of the helicopters prompted intense review of the helicopter triage protocols, as well as operations, equipment, and staffing. The House of Delegates formed an oversight committee that made a number of recommendations regarding the Medevac fleet including the need to move forward with the replacement of the older helicopters and the continuation of the Medevac operations to be housed with the Maryland State Police.
Early in the Session the death penalty took center stage, and later it was dominated by the Preakness Stakes. Though the death penalty was not repealed, the Legislature voted to narrow the application of capital punishment by requiring biological evidence, a videotaped confession, or a videotape of the crime. And at the end of the Session, last-minute efforts led to the passage of legislation that gives the State the power to keep the Preakness in Maryland.
Health Care:SB 852/HB 1366 would have corrected a current practice by health insurance companies that send reimbursement for physician services to the patient even when the patient directs that payment be sent to the physician. The "assignment of benefits" bill did not pass, but the Joint Committee on Health Care Delivery and Financing will be studying this issue during the interim.
The issue of False Health Claims (SB 272/HB 304) was one of the Governor's top priorities this Session. The provider and hospital community was successful in raising its concerns about the qui tam (private cause of action) and whistleblower provisions in the legislation. The Legisalture heard that message and responded by voting down the Senate bill. The response from the Governor and the Administration was to offset the loss in savings, which they had predicted would result from passage of the bill, by reducing appropriations in the Medicaid day limits ($20 million) and Medicaid physician rates for FY2010 ($9 million). This budget action was contingent on the failure of the House bill. Compromise could not be reached, the bills failed to pass and the budget reductions will stand for FY2010. The Governor and Administration are committed to this issue and there most certainly will be legislation introduced next Session.
The eighteen months of work by the Governor's Task Force on Health Care Access and Reimbursement came to fruition in the form of three bills that passed this Session that: adjust the reimbursement formula for providers who do not participate with HMOs (HB 255/SB 380); standardize physician credentialing (HB 526/SB 646); and expand student loan forgiveness programs (HB 714/SB 627).
A number of bills targeted at reforming the health insurance market were debated including efforts to increase the medical loss ratio. While the bills failed, the issue of how much an insurance company spends on healthcare for its subscribers was put out there. In these times of provider shortages and a fraying health care system, closer attention is being paid to who has control of the health care dollars, and where and how they are being spent.
HB 843, which expands the rights of Continuing Care Residents to file a grievance and seek mediation, was successfully passed.
Education & Environment:
Thanks in part to Federal Stimulus Funds, many of the State's education priorities (in K-12 and higher education) were spared from devastating cuts. Many programs took funding cuts or freezes but the doomsday cuts that had been predicted did not come to fruition. In spite of the balanced budget, many of the funding concerns cited this year remain for future budget years.
A major piece of compromise language passed this Session concerning green house gas emissions. The stakeholders involved had worked out the major principles of their agreement prior to the beginning of the 2009 Session which facilitated successful passage of the bill this year.
"Green" buildings and construction projects were both hot topics, as environmentally friendly issues continue to take up a larger part of the overall discussions in Annapolis. Energy utilization, energy rates and alternative fuel sources were all on the table, and consumer concerns over the high cost of electric rates was the universal theme to many of these discussions.
It was a difficult Session clouded by uncertainty over the health, strength, and stability of the State economy and the national economy. Look for more detailed reports specific to your issues in the coming weeks. We will send updates throughout the year on the major issues as they emerge.
Sincerely,
Barbara Brocato
Dan Shattuck
Charlotta Beavers
Barbara Marx Brocato & Associates
18 Pinkney Street
Annapolis, Maryland 21401
Telephone: 410-269-1503
Facsimile: 410-269-5021