5 Things Maryland: Q&A w/ Dr. Margaret Moon, Spending Affordability Briefing, HCBS rate increases


Emily Boerger


With the Thanksgiving holiday this week, I wanted to take a moment to say thank you on behalf of the entire State of Reform team for your continued support. Whether it’s through attending our conferences, reading our coverage of health care and health policy in Maryland, or sponsoring our events, we appreciate you!

Thanks again and happy Thanksgiving!

Emily Boerger
Managing Editor
State of Reform


1. Q&A: Dr. Margaret Moon discusses vaccine distribution for kids

Dr. Margaret Moon is the director of the Department of Pediatrics at Johns Hopkins University School of Medicine. In this Q&A, Moon discusses COVID-19 vaccine distribution plans for children, which include distribution to primary care pediatricians’ offices, mobile clinics, and pharmacies.

She also addresses parents’ vaccine concerns. When thinking about rare side effects like myocarditis among kids who received the vaccine, Moon says it’s important for parents to look at the big picture. “[Myocarditis] was still very rare…But because people worry about vaccines anyway, I think people focus on the risk of the vaccine and forget about the risk of the illness itself.”


2. Health care highlights in the affordability briefing

Medicaid reimbursement rates, behavioral health, COVID relief funds, and more are teed up in Maryland’s fiscal year 2023 budget affordability plan. The Department of Legislative Services’ Office of Policy Analysis released its Spending Affordability Briefing this month, outlining ways the state could appropriate funds ahead of the upcoming legislative session.

The office estimates Medicaid enrollment could drop after the federal public health emergency ends, resulting in a decrease in provider reimbursement rate funding. Potential funding allocations include $68.6 million for local health departments and a $57.5 million increase for the Developmental Disabilities Administration.

3. Video: Bending the Rx cost curve

Improving the accessibility and affordability of biosimilars was a key topic of conversation at our recent “5 Slides: Bending the Rx cost curve” virtual conversation. Sarah Ikenberry at the FDA says biosimilars are underutilized due to a lack of education and awareness from providers. A March 2021 national survey found that about half of providers had no experience prescribing these types of medicines.

Panelists also discussed challenges to affordability including limited transparency and the impact of PBM rebates. “We dehumanize treatment by bringing too many middlemen, by putting extra cost on the people who are least privileged,” said Dr. Kashyap Patel at the Community Oncology Alliance. Video of their full conversation is available here.

4. MDH announces HCBS rate increases

Earlier this month the Department of Health announced Medicaid rate increases for Maryland’s home and community-based services (HCBS) providers. The increases were the result of the state’s FY2022 budget bill, which directs Medicaid to spend at least 75% of ARPA reinvestment dollars on one-time provider rate increases.

The rate increases include a 5.5% increase for most HCBS developmental disability providers, a 5.4% increase for most HCBS behavioral health and Applied Behavior Analysis providers, and a 5.2% increase for community-based long-term services and support providers. The increased rates target services and providers eligible for the 10% enhanced federal match established through ARPA.


5. Gov. Hogan calls for rejection of BBB plan

The US House passed President Biden’s Build Back Better Act on Friday, sending the roughly $2 trillion spending proposal over to the Senate. A fact sheet from the White House states that through the act, 34,000 uninsured Marylanders would gain health coverage and 53,300 would save hundreds of dollars per year on premiums. The plan also invests in affordable child care, universal pre-K, and workforce development.

Following its passage, Gov. Hogan described the bill as “nothing but a reckless grab bag of massive tax hikes, Democratic Party wish list items, and handouts to special interests,” and urged the US Senate to reject the bill. For more details on the health-related provisions in the plan, be sure to check out State of Reform Columnist Jim Capretta’s latest piece.