Depending on whether the governor and legislative leaders can work out their differences on the budget, the last day of the 2015 General Assembly session will be this Monday. This was a unique year for many reasons, notably that a new face in the governor's mansion and more than 60 new delegates and senators created an environment where education about our issues was a top priority, but also where ideas from all sides could be heard by fresh ears.

That meant new opportunities. And new threats.

Next week, we'll provide a snapshot summary of how the bills relevant to hospitals fared, and soon after, stay tuned for an action plan of specific steps to take based on new laws and regulations that were passed.

As you know, playing defense against bad bills and bad policy is just as important as pushing for the right legislation to be enacted. While hospitals were successful this year in fending off myriad harmful proposals, their proponents are already strategizing how to revisit these bills next year. And each year is more challenging, as the legislation is continually refined to address concerns raised in previous sessions. As such, our counterarguments must also be refined.

Here are a few examples of bills that promise to continue popping up even though they were defeated this year: 

• A proposal to triple the cap on noneconomic damages in medical malpractice lawsuits
• A proposal that would have loosened self-referral laws (rules that prevent physicians from referring patients to services in which they have a direct financial interest) for oncologists and for MRI and CT services
• A proposal that would legislate the care process by mandating hepatitis C screening at hospitals
• The Maryland AARP proposal that also would codify care by requiring hospitals to designate and train a patient's caregiver

There are others, of course, but by and large, we've been successful this year in heading off the most detrimental proposals. Now, as session winds down and our opponents begin to figure out how to make these bills more palatable for next year, we will prepare for their re-emergence.

Work through our political action committee and with hospitals to develop strategies to combat these bills again next year will begin soon. As you interact with legislators throughout the year, it helps to remind them that hospitals need leeway and flexibility to provide quality health care and to tailor that care to our patients and communities, not prescriptive legislation that gets between us and that mission.

Getting the right legislation passed and preventing bad bills is a multiyear process. As you know, the effort to provide hospitals the right environment in which to operate doesn't end on Sine Die; it takes the united, relentless force of our field to push policy in the right direction so you can best meet the needs of your patients and communities.

With Sine Die scheduled for midnight Monday, work will continue throughout the weekend as the legislature seeks to finalize the budget and other loose ends before wrapping for 2015.

Regarding MHA priorities still to be finalized, on Tuesday MHA supported SB607-HB896-Joint Committee on Behavioral Health and Opioid Use Disorders, which incorporates the proposed Blue Ribbon Commission on Behavioral Health. This bill specifies the purposes of the committee to review the final report of the Governor's Heroin and Opioid Emergency Task Force, review and monitor the activities of the Governor's Inter-Agency Heroin and Opioid Coordinating Council, evaluate the state's behavioral health system and identify needed funding. Amendments were offered by sponsors to alter the staffing requirements to address fiscal note concerns regarding staffing. 

MHA and several partners were successful in blocking an effort to pass HB1101-Department Health and Mental Hygiene - Health Program Integritiy and Recovery Activities. This legislation would have substantially amended current law governing hospital and other health care provider participation in Medicaid by imposing a substantial risk of recoupment of paid claims not based on identified claims errors (those found not to be eligible for reimbursement) but instead on extrapolated data.

MHA provided additional oral testimony this week in support of SB187- Governor's Workforce Investment Board - Workgroup to Study Access to Obstetric Services, which authorizes the Governor's Workforce Investment Board to coordinate with MHA, in consultation with the Secretary of Health and Mental Hygiene, health occupations boards, the Governor's Workforce Investment Board, and certain other entities and parties, to establish a work group to study access to obstetric services. A report to the governor and certain committees of the General Assembly is due by December 1, 2015.