2001 Legislative Session Wrap-up

by Steven R. Daviss, M.D., Past Chair, MPS Legislative Committee

[Summer 2001; Vol. 28, No. 1; Pg 9-12]

We had a very successful legislative session in 2001. With two of our most important bills (SB854 and HB473) being defeated. We reviewed 116 bills and followed 31 of them closely, identifying 8 of them as critical bills for us. We prevailed in 74% of the bills, supporting 12, which passed, and opposing 11 which failed. Of the bills we supported, 63% passed (12 out of 19). More importantly, of the bills we opposed (12 bills) only one passed. The efforts of the legislative committee members, Jennifer Gajewski, Carol Allen and especially our lobbyist, Franklin Goldstein, were instrumental in our success. More importantly, the letters, faxes and phone calls from MPS members to their elected representatives prevented the erosion of quality psychiatric care in Maryland. When you call Annapolis and identify yourself as a member of the MPS, it makes a difference. Legislative representation is one of the most valuable benefits of MPS membership.

 

Passed

Failed

Total

Supported

12

7

19

Opposed

1

11

12

Total

13

18

31

Note: Support with amendment bills are counted as support or oppose depending on whether the desired amended version passed or failed.

 

MPS Position: SUPPORT          Bill Status: PASSED

Bill Number and Title Synopsis/ Effect of Bill Notes
HB1071/ SB627
Medical Assistance and Children's Health Programs - Reimbursement Rates Fairness Act of 2001
CRITICAL: Provides for a process to annually set the fee-for-service reimbursement rates for the Maryland Medical Assistance Program and the Maryland Children's Health Program in a manner that ensures participation of providers, and compares these rates with those of Medicare and the community. Passed - Signed by Governor
Chapter 702
07/01/2001
SB42
Refusal of Psychiatric Medication - Clinical Review Panel
Extends the termination date of the Clinical Review Panel law to 2005. Passed with amendments - Signed by Governor
Chapter 15
06/01/2001
HB752
Mental Hygiene Law - Advance Directives
Requires that the administrative head of a residential facility providing treatment for individuals with mental disorders who releases an individual from the facility notify the individual of the advisability of developing an advance directive for mental health services; and requiring that the facility assist the individual in developing the advance directive if the individual requests assistance. Advocates find this type of bill preferable to an outpatient commitment law. Passed - Signed by Governor
Chapter 267
07/01/2002
SB856
Health Insurance Appeals and Grievance
Enhances the Appeals & Grievances law to provide more time to file and requires carriers to file quarterly reports with the Commissioner. Passed - Signed by Governor
Chapter 173
10/01/2001
HB149/ SB132
Health Insurance - Standard Provisions
Repealed a current standard provision allowed in health insurance contracts stating that the insurer is not responsible for a loss of which a contributing cause was the insured's commission of or attempt to commit a felony, being engaged in an illegal occupation, or being intoxicated or under the influence of illicit drugs. For instance, an insurer could have avoided paying for treatment of HIV in a prostitute, or a hospital stay after a DWI-related accident. Passed - Signed by Governor
Chapter 26
01/01/2002
HB127
Estates and Trusts - Guardian - Medical Procedures
Allows the court to authorize a guardian to make decisions regarding medical procedures that involve a substantial risk to the life of a disabled person without further court authorization when the guardian is within one of specified classes of individuals and the court determines the guardian is familiar with the personal beliefs, values, and medical situation of the disabled person. Passed - Signed by Governor
Chapter 189
10/01/2001
HB400/ SB293
Creation of a State Debt - Mental Health Association of Montgomery County, Inc.
Provides a grant to MHA in Montgomery County to improve their facility Passed - Signed by Governor
Chapter 222
06/01/2001
HB18/ SB2
Genetic Information - Nondiscrimination in Employment
Makes it an unlawful employment practice for an employer to fail or refuse to hire or discharge an individual or otherwise discriminate against an individual because of the individual's genetic information or the individual's refusal to submit to a genetic test or make available the results of a genetic test. Passed - Signed by Governor
Chapter 12
10/01/2001

MPS Position: SUPPORT WITH AMENDMENTS          Bill Status: PASSED

HB928
Mental Health - Minors - Providers and Consent Provisions
Including psychologists in the medical professionals who may treat minors for specified mental illness; specifying that a psychologist can determine if a minor has the capacity to consent to medical treatment; providing a limited immunity for a psychologist who treats a minor; specifying that a psychologist may, but need not, provide information to specified individuals; specifying that a minor who is 16 years old or older can consent to treatment by a psychologist but cannot refuse treatment under specified circumstances.
Includes our amendment altering the bill to state that the psychologist may provide "psychological treatment" (instead of the previous "medical treatment").
Passed with amendments - Signed by Governor
Chapter 284
10/01/2001
HB78
Mortality Review Committee - Deaths of Individuals in State Facilities and Programs
Requires the Mortality Review Committee in the Department of Health and Mental Hygiene to evaluate causes or factors contributing to deaths in facilities or programs operated or licensed by the Mental Health Administration; requires the Secretary of DHMH to report specified deaths within 24 hours of notification to the Committee; & requires the Office of Health Care Quality to review specified deaths of individuals with mental illness. Passed with amendments - Signed by Governor
Chapter 640
10/01/2001
SB637/ HB493
Medical Assistance and Children's Health Programs - Directory of Health Care Providers
Requires MA to publish a provider directory in paper and internet versions, and that they be maintained "reasonably current". Passed - Signed by Governor
Chapter 413
10/01/2001
HB179
Health Insurance - Private Review Agents
Clarifies that grievances regarding mental health or substance abuse issues be reviewed by a physician who is board certified or eligible in the same specialty as the treatment under review; or is actively practicing or has demonstrated expertise in the substance abuse or mental health service or treatment under review. Passed with amendments - Signed by Governor
Chapter 53
01/01/2002
Committee Abbreviations Key:
ECO: House Economic Matters Committee
ENV: House Environmental Matters Committee
JUD: House Judiciary Committee
BUD: Senate Budget and Taxation Committee
EEA: Senate Economic and Environmental Affairs Committee
FIN: Senate Finance Committee
JPR: Senate Judicial Proceedings Committee

MPS Position: SUPPORT          Bill Status: FAILED

Bill Number and Title Synopsis/ Effect of Bill Notes
SB326/ HB1108
Maryland Medical Assistance Program - Reimbursement for Outpatient Mental Health Treatment - Dual Eligibility
CRITICAL BILL: For patients with both MA & Medicare receiving outpatient mental health services, would have required the Maryland Medical Assistance Program to reimburse specified providers the remaining 50% that Medicare does not, up to the full MA fee. Senate: Passed
House: Died in ENV
HB686/ SB34
Practice of Medicine - Definition
CRITICAL BILL: Would have included within the definition of "practice of medicine" the making of a proposed determination that a health care service is not medically necessary or appropriate for a patient. The better of two "medical directors" bills that would bring UR procedures under potential BPQA review. Senate: Passed with amendments.
House: Un-favorable by ENV & ECO
SB269/ HB488
Health Insurance - Patient Rights - The No More Runaround Act of 2001
Would have provided that specified health insurance carriers may not prohibit or refuse to reimburse a provider on the carrier's provider panel from rendering to enrollees covered health care services within the provider's lawful scope of practice. Would totally eliminate managed care. Senate: Not voted on in FIN
House: Un-favorable by ECO
SJ8
Health Care for All Marylanders
Would have established a Panel on Comprehensive Health Care whose charge would have been to encourage a public-private partnership in developing policies to provide health care coverage for all Marylanders. This will be pushed hard to gather steam for the 2002 elections. Senate: Un-favorable by FIN
HB951
Health Insurance - Requirements for Provider Panels
Would have altered some regulations to improve access to, reduce waiting time for, and ensure an adequate supply of network specialists. House: Un-favorable by ECO
SB328/ HB1247
Department of Health and Mental Hygiene - Mental Health Services - Cost of Living Adjustment
Would have required that beginning fiscal year 2003, the fees paid by the Department of Health and Mental Hygiene to a community mental health services provider for providing mental health services to eligible individuals be adjusted annually by the rate of change in the consumer price index that may not exceed a 5% maximum rate. House: Not voted on in ENV
Senate: Not voted on in FIN & BUD
SB521/ HB676
Health Insurance - Covered Health Care Services - Underlying Medical Conditions
Provided that a covered health care service that health insurance carriers are required to provide shall be deemed to include coverage of a health care service prescribed by a practitioner for treatment of an underlying medical condition if the practitioner determines that the prescribed health care service is medically necessary for the treatment of the covered health care service; etc. WITHDRAWN

MPS Position: OPPOSE          Bill Status: FAILED

SB854
Nurse Psychotherapists-Authority to Prescribe Medications in ProBono Programs
CRITICAL BILL: Same bill as last year. Would have allowed Nurse Psychotherapists to prescribe in collaboration with a physician only in free or reduced rate programs where there were insufficient physician volunteers.

Note that this bill passed this committee in the past.

Senate: was not voted on in EEA.
HB473
Health Maintenance Organizations - Patient Access to Choice of Provider
CRITICAL BILL: Perennial bill to designate Nurse Practitioners (NPs) as “Primary Care Providers” for up to 50% of the PCP panels in HMOs.

Passed House/Senate by 1 vote, after first failing by 1 vote then being “reconsidered”. Governor vetoed it citing lack of consensus and HMOs may pressure patients to accept NPs.

Vetoed by the Governor
SB332/ HB285
Health Insurance Carriers - Standing Referrals to Specialists
Would have altered the definition of "specialist" to include ANY licensed or certified health care provider (eg, a Nursing Aide could be considered a "specialist"), and permit standing referrals to these "specialists". House: Passed
Senate: Un-favorable by FIN
SB772
Health Care - Therapy Management Agreements and Cooperative Procedures
CRITICAL BILL: Would have authorized a licensed pharmacist to enter into a therapy management agreement with a licensed physician, a licensed dentist, or a licensed podiatrist, to alter a patient's medication or dosage within agreed upon parameters. Senate: Referred to Interim Study by EEA
SB499/ HB298
Workers' Compensation - Evaluation of Permanent Impairment - Behavioral or Mental Disorder
Would have required that a permanent impairment that involves a behavioral or mental disorder be evaluated by a licensed psychiatrist, other licensed physician, or a licensed psychologist. Would have permitted an evaluee to be seen by a psychologist and perhaps never by a physician. Also equated the exams of all three types of providers. House: Un-favorable by ECO
Senate: Un-favorable by FIN
SB134/ HB450
Sexually Violent Predators
Would have created a procedure in which a person who has been convicted of or charged with a sexually violent offense and who suffers from a specified mental abnormality or personality disorder may be placed in the custody of the Secretary of Health and Mental Hygiene indefinitely until the person is deemed to be safe to be at large. Would have effectively turned mental health facilities into tools of the penal system. House: Un-favorable by JUD
Senate: Un-favorable by JPR
HB1428
Criminal Procedure - Sexually Violent Predators - Chemical or Physical Treatment
Would have authorized a court to reduce the sentence of specified defendants if the defendant elects to either be given a specified chemical treatment or undergo physical castration as a condition of supervised probation. WITHDRAWN
HB522/ SB547
State Board of Professional Counselors and Therapists
Would have allowed graduate marriage and family therapists and graduate clinical professional counselors to provide services under specified supervision while working towards fulfilling licensing requirements, but would have given them the title as if they were licensed. Governor felt it could confuse the public, and also that while under supervision they were not subject to the Practice Act. Passed
Vetoed - Policy

MPS Position: SUPPORT WITH AMENDMENTS          Bill Status: FAILED

HB223/ SB490
Managed Care Entities - Health Care Treatment Decisions - Liability
CRITICAL BILL: Establishing the liability of specified health insurance carriers and managed care entities for damages that an insured or enrollee suffers as a result of a health care treatment decision of the carrier or managed care entity under specified circumstances; establishing specified defenses; only covers Decisions for treatments already provided, would not have covered denied treatments. House: Unfavorable by ECO.
Senate: no action.
HB1040
Health Insurance - Medical Directors - Regulation
CRITICAL BILL: Would have given the BPQA a greater degree of oversight of licensed medical directors, and provided for professional sanctions if the director "fails to meet appropriate standards of quality medical care as reflected by a determination of the insurance commissioner." This was the compromise bill to HB686, and would not have covered other UR reviewers or ERISA plans. House: Unfavorable by ECO
HB1295
Mental Hygiene Law- Emergency Evaluations Petitions & Procedures
Would have altered the EP law to require petitioners to have "personal knowledge" of the danger; "required" an interested party's name, address and phone; required the petitioner to be present at the hearing; required the ER to notify the interested party within 2 hours; and would have removed the current immunity and exposed petitioners to liability if they could not be shown to have acted "in good faith and with reasonable cause." House: Referred to Interim Study by ENV
We wanted it amended or to fail.

MPS Position: OPPOSE          Bill Status: PASSED

HB770
Mental Hygiene - Emergency Evaluation - Clinical Social Worker
Authorizing clinical social workers to file and present a petition for emergency evaluation of an individual under specified circumstances and defining specified terms. LCSWs will now be able to file EPs without having to go to court. Passed - Signed by Governor
Chapter 270
10/01/2001