Maryland 2023 Regular Session

Maryland Senate Bill SB972 Compare Versions

Only one version of the bill is available at this time.

Old	New	Differences
1	1
2	2
3	3	EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4	4	[Brackets] indicate matter deleted from existing law.
5	5	sb0972
6	6
7	7	SENATE BILL 972
8	8	J5 EMERGENCY BILL 3lr3041
9	9
10	10	By: Senators Zucker, Klausmeier, and Muse
11	11	Introduced and read first time: February 28, 2023
12	12	Assigned to: Rules
13	13
14	14	A BILL ENTITLED
15	15
16	16	AN ACT concerning 1
17	17
18	18	Temporary Medicare Advantage Stabilization Grant Program and Fund – 2
19	19	Establishment 3
20	20
21	21	FOR the purpose of establishing the Temporary Medicare Advantage Stabilization Grant 4
22	22	Program to subsidize certain costs of operating a Medicare Advantage Plan in the 5
23	23	State, offset certain Medicare payment deficiencies, and increase access to certain 6
24	24	Medicare Advantage benefits and plans; establishing the Temporary Medicare 7
25	25	Advantage Stabilization Grant Program Fund as a special, nonlapsing fund; 8
26	26	requiring that the interest earnings of the Fund be credited to the Fund; and 9
27	27	generally relating to the Temporary Medicare Advantage Stabilization Grant 10
28	28	Program. 11
29	29
30	30	BY adding to 12
31	31	Article – Health – General 13
32	32	Section 13–4801 through 13–4807 to be under the new subtitle “Subtitle 48. 14
33	33	Temporary Medicare Advantage Stabilization Grant Program and Fund” 15
34	34	Annotated Code of Maryland 16
35	35	(2019 Replacement Volume and 2022 Supplement) 17
36	36
37	37	BY repealing and reenacting, without amendments, 18
38	38	Article – State Finance and Procurement 19
39	39	Section 6–226(a)(2)(i) 20
40	40	Annotated Code of Maryland 21
41	41	(2021 Replacement Volume and 2022 Supplement) 22
42	42
43	43	BY repealing and reenacting, with amendments, 23
44	44	Article – State Finance and Procurement 24
45	45	Section 6–226(a)(2)(ii)170. and 171. 25
46	46	Annotated Code of Maryland 26
47	47	(2021 Replacement Volume and 2022 Supplement) 27
48	48	2 SENATE BILL 972
49	49
50	50
51	51	BY adding to 1
52	52	Article – State Finance and Procurement 2
53	53	Section 6–226(a)(2)(ii)172. 3
54	54	Annotated Code of Maryland 4
55	55	(2021 Replacement Volume and 2022 Supplement) 5
56	56
57	57	Preamble 6
58	58
59	59	WHEREAS, The Medicare Advantage Program is a federal program aimed at 7
60	60	providing seniors and other Medicare beneficiaries with the choice of a managed care 8
61	61	product that provides supplemental benefits not currently covered by the traditional 9
62	62	Medicare fee–for–service program; and 10
63	63
64	64	WHEREAS, Based on the Centers for Medicare and Medicaid Services–determined 11
65	65	payment tiers, Medicare Advantage Plans may offer low– or no–premium products along 12
66	66	with care coordination support to enrollees and can allow for the expansion of coverage and 13
67	67	benefits to Medicare enrollees throughout the State; and 14
68	68
69	69	WHEREAS, Medicare Advantage Plans have become popular with seniors across the 15
70	70	country, with 48% of Medicare beneficiaries enrolled in Medicare Advantage Plans; and 16
71	71
72	72	WHEREAS, The enrollment rate in Maryland is much lower, with only 13% of 17
73	73	Medicare beneficiaries in Maryland enrolled in Medicare Advantage Plans and the State 18
74	74	having the third lowest Medicare Advantage penetration rate in the nation; and 19
75	75
76	76	WHEREAS, In Baltimore City and Prince George’s County, 80% of those enrolled in 20
77	77	a Medicare Advantage Plan are African American; and 21
78	78
79	79	WHEREAS, Since the early 1970s, Maryland has had a unique hospital rate setting 22
80	80	system to cover the cost of uninsured Marylanders as part of a waiver approved by the 23
81	81	federal government; and 24
82	82
83	83	WHEREAS, This federal waiver presents unique obstacles for Maryland’s Medicare 25
84	84	Advantage Plans due to the federal government’s Medicare Advantage payment 26
85	85	methodology; and 27
86	86
87	87	WHEREAS, The federal Medicare Advantage payment methodology does not 28
88	88	recognize Maryland’s rate setting system when establishing payment tiers; and 29
89	89
90	90	WHEREAS, Maryland Medicare Advantage Plans are in the lowest tier of 30
91	91	reimbursement due to the Maryland rate setting system establishing the rates for hospital 31
92	92	care, including for Medicare Advantage Plans; and 32
93	93
94	94	WHEREAS, Medicare Advantage Plans have experienced significant financial losses 33
95	95	and have either exited the Maryland market or reduced their service areas in the State; 34
96	96	and 35
97	97	SENATE BILL 972 3
98	98
99	99
100	100	WHEREAS, All Maryland seniors are impacted by the lack of Medicare Advantage 1
101	101	options, but experience in other states shows that low–income and minority beneficiaries 2
102	102	are most disadvantaged by the lack of Medicare Advantage options; and 3
103	103
104	104	WHEREAS, The Health Services Cost Review Commission established a 2–year 4
105	105	grant program authorizing $50 million each year to help stabilize the Medicare Advantage 5
106	106	market in the State; and 6
107	107
108	108	WHEREAS, While the grant program helped to stabilize the Medicare Advantage 7
109	109	market, the grant program expired in June 2021; and 8
110	110
111	111	WHEREAS, The Governor Hogan Administration established a Medicare Advantage 9
112	112	Grant Program appropriating $50 million for fiscal year 2023; and 10
113	113
114	114	WHEREAS, While the State is working with the federal government to establish a 11
115	115	permanent Medicare Advantage payment solution, the State must act to stabilize the 12
116	116	Medicare Advantage market in the short term to avoid further Medicare Advantage Plan 13
117	117	service area reductions or market exits that cause severe disruption to Maryland seniors; 14
118	118	now, therefore, 15
119	119
120	120	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
121	121	That the Laws of Maryland read as follows: 17
122	122
123	123	Article – Health – General 18
124	124
125	125	SUBTITLE 48. TEMPORARY MEDICARE ADVANTAGE STABILIZATION GRANT 19
126	126	PROGRAM AND FUND. 20
127	127
128	128	13–4801. 21
129	129
130	130	(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANING S 22
131	131	INDICATED. 23
132	132
133	133	(B) “COMMISSION” MEANS THE MARYLAND HEALTH CARE COMMISSION. 24
134	134
135	135	(C) “FUND” MEANS THE TEMPORARY MEDICARE ADVANTAGE 25
136	136	STABILIZATION GRANT PROGRAM FUND. 26
137	137
138	138	(D) (1) “MEDICARE ADVANTAGE PLAN” MEANS A SPECIFIC PLA N 27
139	139	OFFERED BY A PUBLIC OR PRIVATE ENTITY OR GANIZED AND LICENSED BY A STATE 28
140	140	AS A RISK–BEARING ENTITY THAT IS CERTIFIED BY THE FEDERAL CENTERS FOR 29
141	141	MEDICARE AND MEDICAID SERVICES AS MEETING T HE MEDICARE ADVANTAGE 30
142	142	CONTRACT REQUIREMENTS . 31
143	143
144	144	(2) “MEDICARE ADVANTAGE PLAN” DOES NOT INCLUDE : 32 4 SENATE BILL 972
145	145
146	146
147	147
148	148	(I) A CHRONIC SPECIAL NEEDS PLAN; 1
149	149
150	150	(II) AN INSTITUTIONAL SPECIAL NEEDS PLAN; 2
151	151
152	152	(III) AN EMPLOYER GROUP WAIVER PLAN; 3
153	153
154	154	(IV) A PROGRAM OF ALL–INCLUSIVE CARE FOR THE ELDERLY 4
155	155	(PACE) PLAN; OR 5
156	156
157	157	(V) A PRIVATE FEE–FOR–SERVICE PLAN. 6
158	158
159	159	(E) “PROGRAM” MEANS THE TEMPORARY MEDICARE ADVANTAGE 7
160	160	STABILIZATION GRANT PROGRAM. 8
161	161
162	162	13–4802. 9
163	163
164	164	(A) THERE IS A TEMPORARY MEDICARE ADVANTAGE STABILIZATION 10
165	165	GRANT PROGRAM. 11
166	166
167	167	(B) THE PURPOSE OF THE PROGRAM IS TO PROVIDE GRANTS TO: 12
168	168
169	169	(1) SUBSIDIZE THE DOCUMEN TED COSTS OF OPERATI NG A MEDICARE 13
170	170	ADVANTAGE PLAN IN THE STATE; 14
171	171
172	172	(2) OFFSET THE MEDICARE PAYMENT DEFI CIENCIES THAT OCCUR IN 15
173	173	THE STATE DUE TO HOW THE ALL–PAYER RATE SETTING SYSTEM FOR HOSPITAL 16
174	174	SERVICES IMPACTS THE CENTERS FOR MEDICARE AND MEDICAID 17
175	175	SERVICES–DETERMINED MEDICARE ADVANTAGE PAYMENT TIE RS; AND 18
176	176
177	177	(3) INCREASE ACCESS TO SU PPLEMENTAL MEDICARE ADVANTAGE 19
178	178	BENEFITS AND LOW – OR NO–PREMIUM PLANS TO ENR OLLEES IN THE STATE. 20
179	179
180	180	13–4803. 21
181	181
182	182	THE COMMISSION SHALL ADMI NISTER THE PROGRAM. 22
183	183
184	184	13–4804. 23
185	185
186	186	(A) THE COMMISSION SHALL ESTA BLISH CRITERIA FOR G RANTS TO ENSURE 24
187	187	THAT EFFICIENT AND EFFECT IVE MEDICARE ADVANTAGE PLANS ALIGN WITH THE 25
188	188	PURPOSE OF THE PROGRAM. 26
189	189	SENATE BILL 972 5
190	190
191	191
192	192	(B) THE CRITERIA SHALL : 1
193	193
194	194	(1) INCLUDE CONSIDERATION OF THE MEDICAL COST AND ACUITY OF 2
195	195	SERVING THE MEDICARE ADVANTAGE POPULATION IN A GIVEN JURISDICT ION; AND 3
196	196
197	197	(2) FOR A MEDICARE ADVANTAGE PLAN THAT OPERATED IN THE 4
198	198	STATE ON JANUARY 1, 2022: 5
199	199
200	200	(I) REQUIRE THE MEDICARE ADVANTAGE PLAN TO MAINTAIN 6
201	201	OPERATIONS IN AT LEAST THE SERVICE AREAS WH ERE IT OPERATED IN CALENDAR 7
202	202	YEAR 2022; AND 8
203	203
204	204	(II) PROHIBIT THE MEDICARE ADVANTAGE PLAN FROM 9
205	205	REDUCING THE OFFERING OF BENEFIT PLANS TO ENR OLLEES. 10
206	206
207	207	13–4805. 11
208	208
209	209	THE COMMISSION SHALL PROV IDE GRANTS UNDER THE PROGRAM ON A 12
210	210	QUARTERLY BASIS BASE D ON THE CENTERS FOR MEDICARE AND MEDICAID 13
211	211	SERVICES–APPROVED MEMBERSHIP COUNTS OF MEDICARE ADVANTAGE PLANS IN 14
212	212	THE STATE. 15
213	213
214	214	13–4806. 16
215	215
216	216	(A) THERE IS A TEMPORARY MEDICARE ADVANTAGE STABILIZATION 17
217	217	GRANT PROGRAM FUND. 18
218	218
219	219	(B) THE PURPOSE OF THE FUND IS TO PROVIDE GRANTS UNDER THE 19
220	220	PROGRAM. 20
221	221
222	222	(C) THE COMMISSION SHALL ADMI NISTER THE FUND. 21
223	223
224	224	(D) (1) THE FUND IS A SPECIAL, NONLAPSING FUND THAT IS NOT 22
225	225	SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 23
226	226
227	227	(2) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 24
228	228	AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 25
229	229
230	230	(E) THE FUND CONSISTS OF : 26
231	231
232	232	(1) MONEY APPROPRIATED IN THE STATE BUDGET TO THE FUND; 27
233	233	6 SENATE BILL 972
234	234
235	235
236	236	(2) INTEREST EARNINGS OR OTHER INCOME EARNED FROM THE 1
237	237	INVESTMENT OF ANY MONEY FROM THE FUND; AND 2
238	238
239	239	(3) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FOR 3
240	240	THE BENEFIT OF THE FUND. 4
241	241
242	242	(F) THE FUND MAY BE USED ONLY FOR PROVIDING GRANTS UNDER THE 5
243	243	PROGRAM. 6
244	244
245	245	(G) (1) THE STATE TREASURER SHALL INVES T THE MONEY OF THE FUND 7
246	246	IN THE SAME MANNER AS OTHER STATE MONEY MAY BE IN VESTED. 8
247	247
248	248	(2) ANY INTEREST EARNINGS OF THE FUND SHALL BE CREDITE D TO 9
249	249	THE FUND. 10
250	250
251	251	(H) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION : 11
252	252
253	253	(I) FOR FISCAL YEAR 2024, THE ANNUAL BUDGET BI LL SHALL 12
254	254	INCLUDE AN APPROPRIATION OF $130,000,000 TO THE FUND; AND 13
255	255
256	256	(II) FOR FISCAL YEAR 2025, THE GOVERNOR SHALL INCLUD E 14
257	257	AN AMOUNT IN THE ANN UAL BUDGET BILL FOR THE FUND THAT EQUALS $151 PER 15
258	258	MEMBER PER MONTH FOR EACH ENROLLE E IN A MEDICARE ADVANTAGE PLAN 16
259	259	THAT QUALIFIES UNDER THE PROGRAM. 17
260	260
261	261	(2) THE APPROPRIATIONS UN DER PARAGRAPH (1) OF THIS 18
262	262	SUBSECTION ARE NOT R EQUIRED IF THE FEDERAL GOVER NMENT IMPLEMENTS A 19
263	263	MEDICARE ADVANTAGE PAYMENT SOL UTION FOR THE STATE THAT SATISFIES THE 20
264	264	PURPOSE OF THE PROGRAM. 21
265	265
266	266	(I) MONEY EXPENDED FROM T HE FUND IS SUPPLEMENTAL TO, AND IS NOT 22
267	267	INTENDED TO TAKE THE PLACE OF, FUNDING THAT OTHERWI SE WOULD BE 23
268	268	APPROPRIATED TO MEDICARE ADVANTAGE PLANS. 24
269	269
270	270	13–4807. 25
271	271
272	272	ON OR BEFORE FEBRUARY 1 EACH YEAR, THE COMMISSION, IN CONJUNCTION 26
273	273	WITH THE CHIEF EXECUTIVE OFFICERS OR EXECUTIVE DIRECTORS OF ENTITIES 27
274	274	THAT OFFER MEDICARE ADVANTAGE PLANS THAT QUALIFY FOR GRA NTS UNDER 28
275	275	THE PROGRAM, SHALL REPORT TO THE SENATE FINANCE COMMITTEE, THE SENATE 29
276	276	BUDGET AND TAXATION COMMITTEE, THE HOUSE APPROPRIATIONS COMMITTEE, 30
277	277	AND THE HOUSE HEALTH AND GOVERNMENT OPERATIONS COMMITTEE, IN 31
278	278	ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON: 32 SENATE BILL 972 7
279	279
280	280
281	281
282	282	(1) THE TOTAL AMOUNT AWAR DED TO MEDICARE ADVANTAGE 1
283	283	PLANS IN THE IMMEDIATELY PRECEDIN G CALENDAR YEAR ; 2
284	284
285	285	(2) THE MEDICARE ADVANTAGE PLANS THAT RECEIVED G RANTS 3
286	286	AND THE AMOUNT EACH RECEIVED IN THE IMMEDIATELY PRECEDIN G CALENDAR 4
287	287	YEAR; 5
288	288
289	289	(3) THE IMPACT OF THE PROGRAM ON : 6
290	290
291	291	(I) MEDICARE ADVANTAGE PLAN ENROLLEE BENEFITS BY 7
292	292	COUNTY; AND 8
293	293
294	294	(II) THE AVAILABILITY OF L OW– OR NO–PREMIUM MEDICARE 9
295	295	ADVANTAGE PLANS BY COUNTY; 10
296	296
297	297	(4) THE STATUS OF THE CENTERS FOR MEDICARE AND MEDICAID 11
298	298	SERVICES IMPLEMENTING A MEDICARE ADVANTAGE PAYMENT SOLUTION FOR THE 12
299	299	STATE; AND 13
300	300
301	301	(5) RECOMMENDATIONS FOR T HE FUTURE OF THE PROGRAM OR 14
302	302	OTHER ALTERNATIVES . 15
303	303
304	304	Article – State Finance and Procurement 16
305	305
306	306	6–226. 17
307	307
308	308	(a) (2) (i) Notwithstanding any other provision of law, and unless 18
309	309	inconsistent with a federal law, grant agreement, or other federal requirement or with the 19
310	310	terms of a gift or settlement agreement, net interest on all State money allocated by the 20
311	311	State Treasurer under this section to special funds or accounts, and otherwise entitled to 21
312	312	receive interest earnings, as accounted for by the Comptroller, shall accrue to the General 22
313	313	Fund of the State. 23
314	314
315	315	(ii) The provisions of subparagraph (i) of this paragraph do not apply 24
316	316	to the following funds: 25
317	317
318	318	170. the Cannabis Public Health Fund; [and] 26
319	319
320	320	171. the Community Reinvestment and Repair Fund; AND 27
321	321
322	322	172. THE TEMPORARY MEDICARE ADVANTAGE 28
323	323	STABILIZATION GRANT PROGRAM FUND. 29
324	324	8 SENATE BILL 972
325	325
326	326
327	327	SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency 1
328	328	measure, is necessary for the immediate preservation of the public health or safety, has 2
329	329	been passed by a yea and nay vote supported by three–fifths of all the members elected to 3
330	330	each of the two Houses of the General Assembly, and shall take effect from the date it is 4
331	331	enacted. It shall remain effective through June 30, 2025, and, at the end of June 30, 2025, 5
332	332	this Act, with no further action required by the General Assembly, shall be abrogated and 6
333	333	of no further force and effect. 7