Moore appointees to Md. hospital cost review commission in doubt due to legal questions

Recent appointments from Gov. Wes Moore (D) for a powerful state commission that determines hospital fees are in doubt and one of the new appointees may have to be replaced.

At issue is a state law that limits the number of committee members who represent hospital systems.

To complicate matters, one of the appointees in question is a woman — and advocates say the commission needs more gender parity at a time when reproductive rights are under debate.

Last week, the governor’s office announced three new appointees to the Health Services Cost Review Commission, the state entity that is tasked with constraining hospital costs in Maryland.

“These seven members are the people that decide on hospital fees,” said Senate Executive Nominations Chair Pamela Beidle (D-Anne Arundel). “This is a really important commission.”

One of the new appointees is former Secretary of the Maryland Department of Health Joshua Sharfstein, who is currently a vice dean at Johns Hopkins Bloomberg School of Public Health. The other is Nicki McCann, vice president of provider/payer transformation for the Johns Hopkins Health System, who is scheduled to start in July.

But Maryland law places a limit on how many individuals on the commission can be a part of a regulated entity to avoid potential conflicts of interest, and there cannot be more than three commissioners who have connections “with the management or policy of any facility.” A 1995 ethics decision concluded that a commission employee’s affiliation with Johns Hopkins University violated a state employment conflict law, given the close relationships between the university and Johns Hopkins Health System.

The question is whether Sharfstein and McCann’s appointments violate that provision with their connections with Hopkins, as there are already two commissioners involved with state medical institutions — Commissioner Maulik Joshi, who is president and CEO of Meritus Health, and Commissioner James Elliot, a physician at Luminis Health Doctors Community Medical Center.

The last new appointee is Ricardo Johnson, executive vice president of CareFirst BlueCross BlueShield, but his appointment is not currently in question.

The HSCRC met Wednesday to conduct regular business, and while Johnson was there, Sharfstein was not a part of the panel.

Chair Adam Kane noted Sharfstein’s absence but did not give a reason. That said, the meeting was live-streamed and there was a viewer listed under the name “Joshua Sharfstein.”

The governor’s office did not respond to questions about why Sharfstein did not take part in the meeting. Maryland Matters also contacted the commission, which declined to comment.

“I was told that [he] was asked not to sit in at this meeting this week,” Beidle said.

If current appointments would lead to the commission having too many people who are involved with a regulated entity conflicting with state law, the question arises as to whether Sharfstein or McCann would have to be replaced. And if so, who would get the boot?

It’s unclear what the Moore administration plans to do about the matter.

The appointment process for HSCRC garnered attention well before Moore made these three appointments, with concerns from some lawmakers and activists that the commission does not have enough women as commissioners, particularly since the overturning of federal abortion protections under Roe v. Wade.

Beidle, who has been in leadership on the Senate Executive Nominations Committee since 2019, believed that since two women were coming off of the board, two women should have gone back on the commission.

“Obviously, as a female legislator, I’m concerned that we have the diversity on the board that we need,” Beidle said. “And considering that we’re losing two women, I think we should have replaced them with at least two women.”

“We do have a lot of women’s issues that we are addressing,” she said. “Not just reproductive rights, but maternal health…so I think that its important that we hear from both men and women.”

Before the appointments were announced, the Maryland and Washington D.C., branches of Planned Parenthood sent a letter to Moore, urging the governor to appoint pro-abortion commissioners, specifically women.

“Coming off the historic wins for reproductive health and abortion care during this session of the Maryland General Assembly, it is critical that these vacated seats on the HSCRC be reappointed by women/individuals who are committed to further protecting and expanding reproductive rights and access to reproductive health care services in Maryland,” according to the letter, which was signed by Laura Meyers of Planned Parenthood of Metropolitan Washington, D.C., and Karen Nelson of Planned Parenthood of Maryland.

Moore ultimately appointed only one woman.

If Moore’s recent appointees go through as is, McCann would be taking the spot of current Commissioner Tori Bayless in July, who is the sole women on the commission at the moment. McCann would still be the sole woman on the commission if she maintains her position there.

However, if the issue of both Sharfstein and McCann sitting on the commission together concludes with one appointee needing to be replaced, it is possible that Moore might have to choose between the only female appointee or the former Maryland Health Secretary.

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