MARYLAND: The legislature convened on January 13 and is looking at a nearly $2 billion deficit for fiscal year 2011. Governor Martin O’Malley has ordered over $1 billion in spending reductions since the start of fiscal year 2010, including deep cuts to Medicaid provider and managed care organization reimbursement rates.

With a “rainy day” reserve fund of only $615 million, further reductions to state programs are expected. The state’s weak economy will stall enactment of comprehensive reforms but will not stop the ongoing reform debate. Health care proposals that may be considered in 2010 include restrictions on the use of gender as a rating factor, an autism mandate, an oral chemotherapy parity requirement, and guidelines for the reimbursement of out-of-network providers based on health plan determinations of “usual, reasonable and customary” amounts. Also, Governor O’Malley has announced the appointment of Elizabeth Sammis as Interim Commissioner of the Maryland Insurance Administration.  Last month, Commissioner Ralph S. Tyler announced his resignation to take a job in the Obama administration.