LAWRENCE J. HOGAN, JR., Governor Ch. 667
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Chapter 667
(Senate Bill 734)
AN ACT concerning
Health and Health Insurance Maryland Health Care Commission – Primary
Care Reform Commission Report and Workgroup
FOR the purpose of establishing the Primary Care Reform requiring the Maryland Health
Care Commission to review, examine, and make certain determinations and
recommendations provide an annual report to the Governor and the General
Assembly regarding primary care spending by certain payors of health care services
and improvements to the quality of and access to primary care services; requiring
the Commission to form a workgroup to develop the report; and generally relating to
the Primary Care Reform Maryland Health Care Commission and primary care.
BY adding to
Article – Health – General
Section 20–2201 and 20–2202 to be under the new subtitle “Subtitle 22. Primary
Care Reform Commission” 19–108.4
Annotated Code of Maryland
(2019 Replacement Volume and 2021 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
SUBTITLE 22. PRIMARY CARE REFORM COMMISSION.
20–2201.
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(B) “COMMISSION” MEANS THE PRIMARY CARE REFORM COMMISSION.
(C) “PRIMARY CARE” MEANS HEALTH CARE PR OVIDED IN THE FOLLOW ING
FIELDS OUTPATIENT SE TTINGS:
(1) FAMILY PRACTICE ;
(2) GENERAL PEDIATRICS ;
(3) PRIMARY CARE INTERNAL MEDICINE; AND Ch. 667 2022 LAWS OF MARYLAND
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(4) PRIMARY CARE OBSTETRI CS AND GYNECOLOGY .
(D) “PRIMARY CARE SPENDING ” MEANS ANY EXPENDITUR E OF FUNDS MADE
BY THIRD–PARTY PAYORS , PUBLIC ENTITIES, OR THE STATE FOR THE PURPOSE OF
PAYING FOR PRIMARY C ARE SERVICES OR SUPPORTI NG PRIMARY CARE PROV IDERS,
REGARDLESS OF PAYMEN T METHODOLOGY .
20–2202.
(A) THERE IS A PRIMARY CARE REFORM COMMISSION.
(B) (1) THE COMMISSION CONSISTS O F THE FOLLOWING MEMB ERS:
(I) THREE MEMBERS APPOINT ED BY THE GOVERNOR;
(II) FOUR MEMBERS APPOINTE D BY THE PRESIDENT OF THE
SENATE;
(III) THREE MEMBERS APPOINT ED BY THE SPEAKER OF THE
HOUSE;
(IV) ONE MEMBER DESIGNATED BY THE MARYLAND HOSPITAL
ASSOCIATION;
(V) ONE MEMBER DESIGNATED BY THE MARYLAND NURSES
ASSOCIATION; AND
(VI) ONE MEMBER DESIGNATED BY MEDCHI, THE MARYLAND
STATE MEDICAL SOCIETY.
(2) TO THE EXTENT PRACTIC ABLE, THE MEMBERSHIP OF TH E
COMMISSION SHALL :
(I) HAVE EXPERIENCE IN HE ALTH CARE FINANCING ,
REIMBURSEMENT , AND REGULATION ;
(II) BE COMPOSED OF :
1. PRACTICING PRIMARY CA RE PROVIDERS ;
2. REPRESENTATIVES OF FE DERALLY QUALIFIED
HEALTH CENTERS ;
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3. PROVIDERS FROM PROFES SIONAL PRACTICE
GROUPS;
4. PRIMARY CARE ADVOCATE S;
5. PRIMARY CARE CONSUMER ADVOCATES ;
6. REPRESENTATIVES OF BU SINESSES;
7. HEALTH PLAN REPRESENT ATIVES; AND
8. REPRESENTATIVES OF HO SPITALS OR HEALTH
SYSTEMS; AND
(III) REFLECT THE GEOGRAPHI C DIVERSITY OF THE STATE.
(C) A CHAIR OF THE COMMISSION SHALL BE S ELECTED BY A VOTE OF THE
MEMBERS OF THE COMMISSION.
(D) THE MARYLAND INSURANCE ADMINISTRATION AND TH E DEPARTMENT
SHALL PROVIDE STAFF FOR THE COMMISSION.
(E) (1) THE TERM OF A MEMBER OF THE COMMISSION IS 4 YEARS.
(2) THE TERMS OF THE MEMB ERS ARE STAGGERED AS REQUIRED BY
THE TERMS FOR MEMBERS OF THE COMMISSION ON OCTOBER 1, 2022.
(3) A VACANCY IN THE COMMISSION SHALL BE F ILLED IN THE SAME
MANNER AS THE MEMBER BEING SUCCEEDED WAS APPOINTED.
(F) (1) THE COMMISSION SHALL MEET AS OFTEN AS ITS DUTI ES
REQUIRE, BUT NOT LESS THAN QU ARTERLY.
(2) THE CHAIR OF THE COMMISSION SHALL PROV IDE ALL MEMBERS
WITH NOTICE OF A MEE TING AT LEAST 1 WEEK BEFORE THE DATE OF THE MEETING .
(3) THE CHAIR OF THE COMMISSION SHALL CALL A MEETING AT THE
REQUEST OF A MAJORITY OF THE COMMISSION MEMBERS .
(4) SEVEN MEMBERS OF THE COMMISSION CONSTITUTE A QUORUM.
(5) ACTION BY THE COMMISSION REQUIRES T HE AFFIRMATIVE VOTE
OF A MAJORITY OF THO SE PRESENT ONCE A QU ORUM IS MET.
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(G) A MEMBER OF THE COMMISSION:
(1) MAY NOT RECEIVE COMPEN SATION AS A MEMBER O F THE
COMMISSION; BUT
(2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE
STANDARD STATE TRAVEL REGULATIONS , AS PROVIDED IN THE STATE BUDGET .
(H) THE COMMISSION SHALL :
(1) REVIEW, EXAMINE, AND MAKE DETERM INATIONS REGARDING
PRIMARY CARE SPENDIN G BY ALL PAYORS IN T HE CONTEXT OF OVERAL L HEALTH
CARE SPENDING IN THE STATE; AND
(2) MAKE RECOMMENDATIONS REGARDING :
(I) WAYS TO IMPROVE THE Q UALITY OF AND ACCESS TO
PRIMARY CARE SERVICE S, WITH SPECIAL ATTENTION TO INCREAS ING HEALTH CARE
EQUITY, REDUCING HEALTH CARE DISPARITIES, AND AVOIDING INCREAS ED COSTS
TO PATIENTS AND THE HEALTH CARE SYSTEM ;
(II) MEANS OF REDUCING BAR RIERS TO PRIMARY CAR E ACCESS
AND UTILIZATION IDEN TIFIED BY THE COMMISSION;
(III) PROPOSED CHANGES TO T HE DEFINITION OF “PRIMARY
CARE” FOR THE PURPOSES OF THE COMMISSION’S FUTURE WORK ; AND
(IV) RECOMMENDATIONS TO IN CREASE SPENDING ON P RIMARY
CARE BY THE MARYLAND MEDICAL ASSISTANCE PROGRAM AND HEALTH IN SURERS,
NONPROFIT HEALTH SERVICE PLANS, AND HEALTH MAINTENAN CE ORGANIZATIONS .
(I) (1) (I) EACH MANAGED CARE ORG ANIZATION PARTICIPAT ING IN
THE MARYLAND MEDICAL ASSISTANCE PROGRAM SHALL PROVIDE THE
FOLLOWING INFORMATIO N TO THE COMMISSION:
1. FOR 2017, 2018, 2019, 2020, AND 2021, AND FOR
EACH SUBSEQUENT YEAR ON THE REQUEST OF TH E COMMISSION:
A. THE AMOUNT THE MANAGE D CARE ORGANIZATION
SPENT ON PRIMARY CAR E SERVICES FOR ENROL LEES; AND
B. THE TOTAL AMOUNT THAT THE MANAGED CARE
ORGANIZATION SPENT O N HEALTH CARE SERVICES FOR ENROLLE ES; AND
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2. ANY OTHER INFORMATION REQUESTED BY THE
COMMISSION.
(II) THE SECRETARY SHALL :
1. ENFORCE THE PROVISION S OF SUBPARAGRAPH (I) OF
THIS PARAGRAPH ; AND
2. ADOPT REGULATIONS TO PROTECT THE
CONFIDENTIALITY OF A NY PROPRIETARY INFORMAT ION PROVIDED TO THE
COMMISSION UNDER THIS PARAGRAPH .
(2) (I) EACH INSURER , NONPROFIT HEALTH SER VICE PLAN, AND
HEALTH MAINTENANCE O RGANIZATION THAT PRO VIDES HOSPITAL , MEDICAL, OR
SURGICAL BENEFITS TO INDIVIDUALS UNDER HE ALTH INSURANC E POLICIES OR
CONTRACTS THAT ARE D ELIVERED IN THE STATE SHALL PROVIDE T HE FOLLOWING
INFORMATION TO THE COMMISSION:
1. FOR 2017, 2018, 2019, 2020, AND 2021, AND FOR
EACH SUBSEQUENT YEAR ON THE REQUEST OF TH E COMMISSION:
A. THE AMOUNT THE ENTITY SPENT ON PRIMARY CAR E
SERVICES FOR ENROLLE ES; AND
B. THE TOTAL AMOUNT THAT THE ENTITY SPENT ON
HEALTH CARE SERVICES FOR ENROLLEES ; AND
2. ANY OTHER INFORMATION REQUESTED BY THE
COMMISSION.
(II) THE MARYLAND INSURANCE COMMISSIONER SHALL :
1. ENFORCE THE PROVISION S OF SUBPARAGRAPH (I) OF
THIS PARAGRAPH ; AND
2. ADOPT REGULATIONS TO PROTECT THE
CONFIDENTIALITY OF A NY PROPRIETARY INFOR MATION PROVIDED TO T HE
COMMISSION UNDER THIS PARAGRAPH .
(J) THE COMMISSION MAY ACCEPT FUNDING OR GRANTS TO AID IN THE
WORK OF THE COMMISSION.
19–108.4.
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(A) IN THIS SECTION, “PRIMARY CARE ” MEANS HEALTH CARE PR OVIDED IN
THE FOLLOWING FIELDS ’ OUTPATIENT SETTINGS :
(1) FAMILY MEDICINE ;
(2) GENERAL PEDIATRICS ;
(3) PRIMARY CARE INTERNAL MEDICINE; AND
(4) PRIMARY CARE OBSTETRI CS AND GYNECOLOGY ;
(5) PRIMARY CARE NURSE PR ACTITIONER SERVICES ; AND
(6) PRIMARY CARE MIDWIFER Y.
(K) (B) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2023
2024, THE COMMISSION SHALL PROV IDE A REPORT TO THE GOVERNOR AND, IN
ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL
ASSEMBLY THAT INCLUDE S:
(1) AN ANALYSIS OF PRIMAR Y CARE SPENDING INVESTMENT OVER
THE IMMEDIATELY PREC EDING YEAR, INCLUDING DATA STRAT IFIED BY ZIP CODE
AND COUNTY, IN RELATION TO TOTAL HEALTH CARE SPENDING OVER THE PREVIOUS
YEAR; AND
(2) WAYS TO IMPROVE THE Q UALITY OF AND ACCESS TO PRIMARY
CARE SERVICES , WITH SPECIAL ATTENTI ON TO INCREASING HEALTH CARE EQUITY,
REDUCING HEALTH CARE DISPARITIES, AND AVOIDING INCREAS ED COSTS TO
PATIENTS AND THE HEA LTH CARE SYSTEM ; AND
(2) (3) ANY FINDINGS AND RECO MMENDATIONS OF THE
COMMISSION.
(C) (1) THE COMMISSION SHALL FORM A WORKGROUP TO D EVELOP THE
REPORT REQUIRED UNDE R SUBSECTION (B) OF THIS SECTION , INCLUDING BY
INTERPRETING THE RES ULTS OF THE REQUIRED ANALYSIS AND MAKING THE
RECOMMENDATIONS .
(2) THE WORKGROUP REQUIRE D UNDER THIS SUBSECT ION SHALL
INCLUDE REPRESENTATI VES OF:
(I) THE MARYLAND PRIMARY CARE PROGRAM;
(II) THE HEALTH SERVICES REVIEW COMMISSION; LAWRENCE J. HOGAN, JR., Governor Ch. 667
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(III) THE MARYLAND INSURANCE ADMINISTRATION ;
(IV) THE HEALTH CARE FINANCING DIVISION OF THE
MARYLAND DEPARTMENT OF HEALTH;
(V) THE PRIMARY CARE COMM UNITY, INCLUDING FROM THE
MARYLAND ACADEMY OF FAMILY PHYSICIANS, THE MARYLAND CHAPTER OF THE
AMERICAN ACADEMY OF PEDIATRICS, THE MARYLAND SECTION OF THE AMERICAN
COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS , THE MARYLAND NURSES
ASSOCIATION, THE MARYLAND AFFILIATE – AMERICAN COLLEGE OF NURSE
MIDWIVES, THE MARYLAND COMMUNITY HEALTH SYSTEM, AND THE MIDATLANTIC
ASSOCIATION OF COMMUNITY HEALTH CENTERS;
(VI) PAYORS OF PRIMARY CAR E SERVICES , INCLUDING
CARRIERS AND MANAGED CARE ORGANIZATIONS ;
(VII) HEALTH SERVICES R ESEARCHERS WITH EXPE RTISE IN
PRIMARY CARE ; AND
(VIII) OTHER INTERESTED STAK EHOLDERS.
SECTION 2. AND BE IT FURTHER ENACTED, That the terms of the initial
members of the Primary Care Reform Commission shall expire as follows:
(1) four members in 2024;
(2) four members in 2025; and
(3) five members in 2026.
SECTION 2. AND BE IT FURTHER ENACTED, That:
(a) Before the Maryland Health Care Commission begins the analysis required
under Section 1 of this Act, the Commission shall establish a plan for the analysis and
report after receiving input and agreement from participants in the workgroup as to the
scope of and methodology for the analysis and report.
(b) On or before December 1, 2023, the Commission shall provide the plan
required under subsection (a) of this section to the Governor and, in accordance with §
2–1257 of the State Government Article, the General Assembly.
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2022.
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Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.