2018 Legislative Updates

February 26, 2018
As noted last week, the cross-file to Senate Bill 522 (HB 653) was heard this week in HGO. The bill requires providers to give the patient certain warnings and information about the dangers of opioids when prescribing an opioid. The hearing largely proceeded as the Senate hearing did last week. Chairman Pendergrass said that the issue will be sent to the committee's Opioid Workgroup. They may discuss amending the bill to resemble the approach taken last year on 7-day supply, and basically require providers to adhere to standard of care guidelines.

The Senate version of the concussion bill (Senate Bill 840)  will be heard this Wednesday, Feb. 28.  Last week, the Education Subcommittee of the House Ways & Means Committee met to consider Del. Hill's concussion bill.  The Subcommittee Chair opened the discussion by noting the sponsor had submitted several amendments, some of which conflicted with one another, and it was a complicated bill.  He suggested they put off working on the bill (noting in part that the related youth sports bill was going to be a long controversial hearing) until after they finished the other business they have to do this Session.  Essentially, this likely means the bill isn't going anywhere.

The youth sports bill mentioned above, House Bill 1210, will be heard in the House Ways & Means Committee this Friday, March 2.  It is expected to be a lengthy hearing with many opponents.  There is no Senate cross-file.

On Thursday, House Health and Government Operations will hear House Bill 1430, which changes the term "podiatrist" to "podiatrist physician."  MedChi will be opposing and MOA has now lined up Dr. Humbyrd and others to testify with them.

February 19, 2018
A brief update of this week's activities.  There are now 1150 Senate bills and 1719 House bills.  The next few weeks have extensive hearing schedules.

Delegate Hill's concussion bill (HB 552) was held in Ways & Means on Thursday.  The Senate cross-file (SB 840) is being heard on Feb. 28.  Del. Hill's more far-reaching bill prohibiting contact sports until high school (HB 1210) is being heard March 2.  Testimony from proponents of the bill was rather disjointed, mostly about the danger of concussions in youth sports; not much about the actual provisions of the bill.  She faced a lot of questioning from committee members and didn't do a great job answering them.  She said she had a package of amendments, but no one seemed to have seen them so it was not a productive dialogue at all.

MedChi and the county boards of education were the only opponents.  The athletic trainers and nurses took some sort of support with amendments position, as they wanted to say they support the intent of the bill.  Pam Kasemeyer testified for MedChi.  She noted she had not seen the amendments and would review them, but as introduced there is concern about changing the definition of concussion and having non-clinical people onsite responsible for diagnosing head injuries and making decisions about return to play.  The Education Subcommittee has scheduled a work Session on the bill for Tuesday; hopefully the amendments will be known by then.  Given their agenda and amount of time they have, I don't think they will bring any closure to the bill next week.

We continue to follow a number of opioid-related and PDMP bills.  Most notable this week was legislation to require providers to give certain information and warnings to patients upon prescribing opioids (Senate Bill 522).  MedChi opposed, citing the invasive nature of legislating standard of care issues.  The cross-file of the bill will be heard Wednesday.

February 10, 2018
This week marked the "bill introduction date" in both the House and Senate.  This is the last day a member can introduce a bill without it being assigned to the Rules Committee, a procedural hurdle that does not mean much until the latter days of Session.  There are 1078 bills in the Senate, and 1670 in the House - a large number, particularly in an election year.

As was the case last year, a fair number of opioid-related bills have been introduced.  Some seek to strengthen the Prescription Drug Monitoring Program, turning it into more of an enforcement tool.  These bills have been opposed by MedChi and seem unlikely to pass this year.  A wide variety of bills on opioid education, prevention, enforcement, etc have again been introduced.

MOA supported legislation that revises Athletic Trainer laws in the House this week (House Bill 497), at the request of the athletic trainers.  These bills were reviewed to make sure that athletic trainers are required to perform under the direct supervision of a physician before MOA supported them.

There is a pending study of Maryland's Certificate of Need process before the Maryland Health Care Commission.  Despite the pending study, Kaiser has introduced a bill (Senate Bill 619) that will loosen the CON requirements when they construct facilities for the use of their subscribers.  MHCC has come out in support of the bill; MedChi took no position; and the hospitals are still considering their position, but seem unlikely to strongly oppose the bill, particularly in light of MHCC's support for the bill even before a broader study is complete. The Senate hearing is scheduled for March 1.  A House cross-file (House Bill 1282) was introduced at the end of the week; no hearing has been scheduled.

There has been much attention on the issue of youth sports recently, and legislation has been introduced to, among other things, generally prohibit the playing of youth sports (through middle school) on public property (House Bill 1210).  There has been significant pushback from youth sports leagues ("Maryland Tackle Football Bill Absorbs Early Hits") and the potential Senate sponsor reconsidered and didn't introduce the bill.  The House Bill is sponsored by Del. Terri Hill (a physician and D-Howard/Baltimore Counties).  Del. Hill has also sponsored legislation (House Bill 552) aimed at concussions in youth sports.  The bill has raised great concern from MedChi, nurses, other medical providers, and MOA members because of the potential impact it has on recruiting youth coaches, alteration of the definition of concussion and, more importantly, its ill-advised provision to have non-medical personnel who have received online training be responsible for the "on-site management of all concussion or head injuries during each practice or game, including final decisions regarding a student's removal from the game."  Many health providers have contacted Del. Hill to relay their concerns, including MOA members.  Amendments are apparently being drafted, but it is unclear what they are and whether any amendments can even fix the bill.  A hearing is scheduled in the House for February 15; the Senate hearing is February 28.  MOA is working with MedChi to make sure physicians' concerns are heard.

Finally, long-serving Chairman of the Senate Budget & Taxation Committee Ed Kasemeyer (D-Howard/Baltimore Counties) announced that he will not be running for re-election, joining a large and growing list of legislators that are retiring or seeking other office.  Sen. Kasemeyer is widely regarded as a thoughtful, common sense moderate and his presence will be missed.