This week, the Maryland Health Care Commission (MHCC) work group studying self-referral laws for physicians held its second meeting, discussing how participation in shared savings programs or enhanced quality reporting could be conditions for new exceptions to existing law. At the table were seven hospital representatives - a number that is worth noting because the initial composition of the group had just three.

The expanded representation on this important panel is the result of work that your MHA is doing to remain vigilant against efforts - even when the General Assembly isn't in session - to undermine your ability to provide quality, efficient care to your patients and communities. A recent and ongoing push to loosen self-referral regulations is among them.

As you know, during the past legislative session we were able to fend off legislation that would have watered down self-referral laws related to oncology radiation therapy services and CT services, and potentially cast doubt on the intentions of physicians' decisions. But supporters of this endeavor are regrouping and reinforcing to make another push in 2016.

The report from the work group, due to MHCC in the fall and to the House Health & Government Operations Committee in December, will be a factor in next year's debate. That's why it was so critical to ensure that the group included a greater voice for hospitals, and to augment our argument that doctors and others should make decisions based on the needs of patients and not on the potential for financial gain.

To build the case for next year, MHA is working to help legislators fully understand that this is not a local effort among local provider businesses, but rather a well-funded national effort by large corporations that want to get a foothold in the Maryland market. It has little if anything to do with what's best for the care Marylanders receive.

In addition, MHA is helping lawmakers understand the straw-man "access" argument that proponents have put forward. They argue, for example, that some patients have to travel several hours from home to receive the care they need. But, in fact, 42 hospitals throughout the state currently offer radiation therapy services, and some have already begun free transportation programs for patients who live in more remote areas.