EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0734*
SENATE BILL 734
J1, J5 2lr2423
By: Senator Lam
Introduced and read first time: February 7, 2022
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Health and Health Insurance – Primary Care Reform Commission 2
FOR the purpose of establishing the Primary Care Reform Commission to review, examine, 3
and make certain determinations and recommendations regarding primary care 4
spending by certain payors of health care services and improvements to the quality 5
of and access to primary care services; and generally relating to the Primary Care 6
Reform Commission. 7
BY adding to 8
Article – Health – General 9
Section 20–2201 and 20–2202 to be under the new subtitle “Subtitle 22. Primary 10
Care Reform Commission” 11
Annotated Code of Maryland 12
(2019 Replacement Volume and 2021 Supplement) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Health – General 16
SUBTITLE 22. PRIMARY CARE REFORM COMMISSION. 17
20–2201. 18
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 19
INDICATED. 20
(B) “COMMISSION” MEANS THE PRIMARY CARE REFORM COMMISSION. 21
2 SENATE BILL 734
(C) “PRIMARY CARE” MEANS HEALTH CARE PROVIDED IN THE FOLLOWING 1
FIELDS OUTPATIENT SETTINGS : 2
(1) FAMILY PRACTICE ; 3
(2) GENERAL PEDIATRICS ; 4
(3) PRIMARY CARE INTERNAL MEDICINE; AND 5
(4) PRIMARY CARE OBSTETRI CS AND GYNECOLOGY . 6
(D) “PRIMARY CARE SPENDING ” MEANS ANY EXPENDITURE OF FUNDS MADE 7
BY THIRD–PARTY PAYORS , PUBLIC ENTITIES, OR THE STATE FOR THE PURPOSE OF 8
PAYING FOR PRIMARY C ARE SERVICES OR SUPP ORTING PRIMARY CARE PROVIDERS, 9
REGARDLESS OF PAYMEN T METHODOLOGY . 10
20–2202. 11
(A) THERE IS A PRIMARY CARE REFORM COMMISSION. 12
(B) (1) THE COMMISSION CONSISTS OF THE FOLL OWING MEMBERS : 13
(I) THREE MEMBERS APPOINT ED BY THE GOVERNOR; 14
(II) FOUR MEMBERS APPOINTED BY THE PRESIDENT OF THE 15
SENATE; 16
(III) THREE MEMBERS APPOINTED BY THE SPEAKER OF THE 17
HOUSE; 18
(IV) ONE MEMBER DES IGNATED BY THE MARYLAND HOSPITAL 19
ASSOCIATION; 20
(V) ONE MEMBER DESIGNATED BY THE MARYLAND NURSES 21
ASSOCIATION; AND 22
(VI) ONE MEMBER DESIGNATED BY MEDCHI, THE MARYLAND 23
STATE MEDICAL SOCIETY. 24
(2) TO THE EXTENT PRACTIC ABLE, THE MEMBERS HIP OF THE 25
COMMISSION SHALL : 26
SENATE BILL 734 3
(I) HAVE EXPERIENCE IN HEALTH CARE FINAN CING, 1
REIMBURSEMENT , AND REGULATION ; 2
(II) BE COMPOSED OF: 3
1. PRACTICING PRIMARY CA RE PROVIDERS ; 4
2. REPRESENTATIVES OF FEDERALLY QUALIFIED 5
HEALTH CENTERS ; 6
3. PROVIDERS FROM P ROFESSIONAL PRACTICE 7
GROUPS; 8
4. PRIMARY CARE ADVOCATE S; 9
5. PRIMARY CARE CONSUMER ADVOCATES; 10
6. REPRESENTATIVES OF B USINESSES; 11
7. HEALTH PLAN REPRESENTATIVES ; AND 12
8. REPRESENTATIVES OF H OSPITALS OR HEALTH 13
SYSTEMS; AND 14
(III) REFLECT THE GEOGRAPHIC D IVERSITY OF THE STATE. 15
(C) A CHAIR OF THE COMMISSION SHALL BE S ELECTED BY A VOTE OF THE 16
MEMBERS OF THE COMMISSION. 17
(D) THE MARYLAND INSURANCE ADMINISTRATION AND TH E DEPARTMENT 18
SHALL PROVIDE STAFF FOR THE COMMISSION. 19
(E) (1) THE TERM OF A MEMBER OF THE COMMISSION IS 4 YEARS. 20
(2) THE TERMS OF THE MEMB ERS ARE STAGGERED AS REQUIRED BY 21
THE TERMS FOR MEMBER S OF THE COMMISSION ON OCTOBER 1, 2022. 22
(3) A VACANCY IN THE COMMISSION SHALL BE F ILLED IN THE SAME 23
MANNER AS THE MEMBER BEING SUCCEEDED WAS APPOINTED. 24
(F) (1) THE COMMISSION SHALL MEET AS OFTEN AS ITS DUTI ES 25
REQUIRE, BUT NOT LESS THAN QUARTERLY . 26
4 SENATE BILL 734
(2) THE CHAIR OF THE COMMISSION SHALL PROV IDE ALL MEMBERS 1
WITH NOTICE OF A MEE TING AT LEAST 1 WEEK BEFORE THE DATE OF THE M EETING. 2
(3) THE CHAIR OF THE COMMISSION SHALL CALL A MEETING AT THE 3
REQUEST OF A MAJORIT Y OF THE COMMISSION MEMBERS . 4
(4) SEVEN MEMBERS OF THE COMMISSION CONSTITUTE A QUORUM. 5
(5) ACTION BY THE COMMISSION REQUIRES T HE AFFIRMATIVE VOTE 6
OF A MAJORITY OF THOSE PRESENT ONCE A QUORUM IS MET. 7
(G) A MEMBER OF THE COMMISSION: 8
(1) MAY NOT RECEIVE COMPE NSATION AS A MEMBER OF THE 9
COMMISSION; BUT 10
(2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE 11
STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET . 12
(H) THE COMMISSION SHALL: 13
(1) REVIEW, EXAMINE, AND MAKE DETERMINATI ONS REGARDING 14
PRIMARY CARE SPENDIN G BY ALL PAYORS IN THE CONTEXT OF OVERALL HEALTH 15
CARE SPENDING IN THE STATE; AND 16
(2) MAKE RECOMMENDATIONS REGARDING: 17
(I) WAYS TO IMPROVE THE QUALITY OF AND A CCESS TO 18
PRIMARY CARE SERVICE S, WITH SPECIAL ATTENTI ON TO INCREASING HEALTH CA RE 19
EQUITY, REDUCING HEALTH CARE DISPARITIES, AND AVOIDING INCREAS ED COSTS 20
TO PATIENTS AND THE HEALTH CARE SYSTEM ; 21
(II) MEANS OF REDUCING BARRIERS TO PRIMARY CARE ACCESS 22
AND UTILIZATION IDEN TIFIED BY THE COMMISSION; 23
(III) PROPOSED CHANGES TO THE DEFINITION OF “PRIMARY 24
CARE” FOR THE PURPOSES OF THE COMMISSION’S FUTURE WOR K; AND 25
(IV) RECOMMENDATIONS TO IN CREASE SPENDING ON P RIMARY 26
CARE BY THE MARYLAND MEDICAL ASSISTANCE PROGRAM AND HEALTH IN SURERS, 27
NONPROFIT HEALTH SER VICE PLANS, AND HEALTH MAINTENAN CE ORGANIZATIONS . 28
SENATE BILL 734 5
(I) (1) (I) EACH MANAGED CARE ORG ANIZATION PARTICIPAT ING IN 1
THE MARYLAND MEDICAL ASSISTANCE PROGRAM SHALL PROVIDE THE 2
FOLLOWING INFORMATIO N TO THE COMMISSION: 3
1. FOR 2017, 2018, 2019, 2020, AND 2021, AND FOR 4
EACH SUBSEQUENT YEAR ON THE REQUEST OF TH E COMMISSION: 5
A. THE AMOUNT THE MANAGED CARE ORGANIZ ATION 6
SPENT ON PRIMARY CARE SERVICES FOR ENROLLEES ; AND 7
B. THE TOTAL AMOUNT THAT THE MANAGED CAR E 8
ORGANIZATION SPENT ON HEALTH CARE SERVICES FOR ENROLLE ES; AND 9
2. ANY OTHER INFORMATION REQUESTED BY THE 10
COMMISSION. 11
(II) THE SECRETARY SHALL : 12
1. ENFORCE THE PROVISION S OF SUBPARAGRAPH (I) OF 13
THIS PARAGRAPH ; AND 14
2. ADOPT REGULATIONS TO PROTECT THE 15
CONFIDENTIALITY OF A NY PROPRIETARY INFOR MATION PROVIDED TO T HE 16
COMMISSION UNDER THIS PARAGRAPH . 17
(2) (I) EACH INSURER , NONPROFIT HEALTH SER VICE PLAN, AND 18
HEALTH MAINTENANCE O RGANIZATION THAT PRO VIDES HOSPITAL , MEDICAL, OR 19
SURGICAL BENEFITS TO INDIVIDU ALS UNDER HEALTH INS URANCE POLICIES OR 20
CONTRACTS THAT ARE D ELIVERED IN THE STATE SHALL PROVIDE T HE FOLLOWING 21
INFORMATION TO THE COMMISSION: 22
1. FOR 2017, 2018, 2019, 2020, AND 2021, AND FOR 23
EACH SUBSEQUENT YEAR ON THE REQUEST OF TH E COMMISSION: 24
A. THE AMOUNT THE ENTITY SPENT ON PRIMARY CAR E 25
SERVICES FOR ENROLLE ES; AND 26
B. THE TOTAL AMOUNT THAT THE ENTITY SPENT ON 27
HEALTH CARE SERVICES FOR ENROLLEES; AND 28
2. ANY OTHER INFORMATION REQUESTED BY THE 29
COMMISSION. 30
6 SENATE BILL 734
(II) THE MARYLAND INSURANCE COMMISSIONER SHALL: 1
1. ENFORCE THE PROVISION S OF SUBPARAGRAPH (I) OF 2
THIS PARAGRAPH ; AND 3
2. ADOPT REGULATIONS TO PROTECT THE 4
CONFIDENTIALITY OF ANY PROPRIETARY INFO RMATION PROVIDED TO THE 5
COMMISSION UNDER THIS PARAGRAPH . 6
(J) THE COMMISSION MAY ACCEPT FUNDING OR GRANTS TO AID IN THE 7
WORK OF THE COMMISSION. 8
(K) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2023, THE 9
COMMISSION SHALL PROVIDE A REPORT TO THE GOVERNOR AND , IN ACCORDANCE 10
WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY 11
THAT INCLUDES : 12
(1) AN ANALYSIS OF PRIMAR Y CARE SPENDING OVER THE 13
IMMEDIATELY PRECEDIN G YEAR, INCLUDING DATA STRAT IFIED BY ZIP CODE AND 14
COUNTY, IN RELATION TO TOTAL HEALTH CARE SPENDING OVER THE PREVIOUS 15
YEAR; AND 16
(2) ANY FINDINGS AND RECO MMENDATIONS OF THE COMMISSION. 17
SECTION 2. AND BE IT FURTHER ENACTED, That the terms of the initial 18
members of the Primary Care Reform Commission shall expire as follows: 19
(1) four members in 2024; 20
(2) four members in 2025; and 21
(3) five members in 2026. 22
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
October 1, 2022. 24