Health care highlights in Maryland’s latest budget briefing

Medicaid reimbursement rates, behavioral health, COVID relief funds, and more are tee’d up in Maryland’s fiscal year 2023 budget plan. The Department of Legislative Services’ Office of Policy Analysis released its Spending Affordability Briefing this month, and outlined appropriations ahead of the upcoming legislative session. 

 

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Due to an influx of federal aid, such as increased Federal Medical Assistance Percentages (FMAP) and American Rescue Plan Act (ARPA) dollars, the state general fund spending for fiscal year 2023 is estimated to decrease by $128.1 million.

 

Image: Office of Policy Analysis, Department of Legislative Services

 

See funds for specific health issues below: 

 

COVID-19 

The fiscal year 2023 baseline budget will remove one-time, COVID-related, federal funds for a number of public health services and replace them with general funds: 

  • The Epidemiology and Laboratory Capacity (ELC) Enhancing Detection Expansion received $174 million in federal funding in 2021. However, it will receive only $3.5 million in general funds in fiscal year 2023. The rest will come from other federal funds that are not included in the baseline  because “the amount that will be spent in fiscal 2023 is uncertain,” according to the brief.
  • $13.7 million for statewide COVID-19 vaccine operations
  • $3.2 million for substance abuse prevention and treatment

 

Medicaid 

State Medicaid programs are expected to begin an eligibility renewal process following the end of the public health emergency (PHE) declaration. In 2021, average monthly Medicaid enrollment increased by 129,751 for a total of 1.6 million beneficiaries. The fiscal year 2023 baseline estimates monthly enrollment will decrease by 110,380 after the PHE ends.

The budget outlines the following reimbursement rates for Medicaid-funded providers, including behavioral health providers, from fiscal year 2021 to 2023. A total reduction of $277.1 million, or 2%, is due to the estimated drop in enrollment, as well as a deficiency from repaying outstanding behavioral health services from fiscal year 2021.

 

Image: Office of Policy Analysis, Department of Legislative Services

 

Behavioral health, SUD, and developmental disabilities 

The Maryland Behavioral Health Administration will receive a $4 million increase in fiscal year 2023 general funds for fee-for-service programs. This corresponds to an anticipated increase in residential substance use disorder services. The program provides behavioral health services for those who are Medicaid-eligible but are not currently enrolled.

Funds for the Prevention and Health Promotion Administration decreased by $9.3 million in the fiscal year 2023 baseline, as funding from the State Opioid Response (SOR) II grant ends on September 30, 2022. 

To support a 4% increase in provider rates, the budget for the Developmental Disabilities Administration will increase by $57.5 million. Additionally, $24.3 million of state and federal funds will go towards supporting the Community Services Program.

 

Health Equity 

The Maryland Community Health Resources Commission (CHRC) received $13 million in fiscal year 2021 to fund health equity grants under the RELIEF Act. The funding extended into fiscal year 2022, as well as a $1.17 million provision in the fiscal year 2023 baseline budget.

The Office of Minority Health and Health Disparities will receive a projected $290,500 increase in funding in fiscal year 2023.

 

Local health departments 

Local health departments (LHD) will receive $68.6 million in state aid from the fiscal year 2023 baseline budget. This is just 0.7% of the $9.4 billion available. Approximately 86%, or $8 billion, will go to public schools. Of the LHD share, $17.5 million come from federal COVID-19 related grants. 

 

More details from the affordability plan can be found here.