Opinion: Why Maryland needs a new health care regulatory agency

By Anna C. Palmisano

The writer is director of Marylanders for Patient Rights and holds a doctorate in microbiology. 

As the 2024 legislative session of the Maryland General Assembly begins, I would like to provide a cautionary tale for those legislators and advocates working on health care bills. Even if a health care bill successfully passes the legislature, implementation may be virtually non-existent. Why?

Health care laws, like any laws, require active oversight by governmental agencies. The situation in our state is complicated. Many bills point to the state agency called the Office of Health Care Quality (OHCQ) as the lead in oversight.

According to the Maryland Department of Health website, “the quality of care and compliance with both State and federal regulations in 18,032 health-care facilities and health-related services and programs is monitored by the Office.” However, in numerous meetings and communications with the office’s director over the past few years, the agency was described as strictly “complaint-driven.” The office will not provide oversight to ensure that the laws are implemented unless they are responding to a specific complaint.

For a new health care law, this poses a proverbial “catch-22” situation. Patients often are not aware of a new law, so they would not know to file a complaint when that law is violated. In other words, they don’t know what they don’t know.

The Hospital Patient’s Bill of Rights is prime example of lack of oversight by OHCQ resulting in a failure of compliance with the Maryland health care law.

The Hospital Patient’s Bill of Rights was passed unanimously by the General Assembly in 2019 and signed into law by then-Gov. Larry Hogan (R). The Marylanders for Patient Rights Coalition led the advocacy effort.

The law provides protections for patients by requiring hospitals to:

• Provide each patient with a written copy of the Patient’s Bill of Rights;
• Conspicuously post copies of the Patient’s Bill of Rights; and
• Provide annual training to all medical staff on the patient rights law.

Patient rights include treatment without discrimination, receiving information in a manner understandable to the patient, involvement with the plan of care, informed consent, and other important rights that have precedence in federal and state laws.

The Hospital Patient’s Bill of Rights simply mandated that this information be shared with the patient.

In 2023, I randomly surveyed 16 Maryland hospitals for compliance with the 2019 law.

None of the hospitals surveyed had complied with the law.

In fact, one of our advocates who was blind brought a copy of the law with him to his local hospital where he was told that the law did not exist.

Clearly, there is a serious lack of needed oversight of laws that protect patients. A new Maryland regulatory agency should be created to take responsibility for proactive oversight of health care laws to ensure the protection of patients and compliance with laws by health care providers.

A Health Care Regulatory Agency, under the aegis of the Maryland Department of Health, should be provided with the resources, both personnel and funding, to do more than just respond to complaints. The new agency would regularly monitor providers for implementation of laws that improve quality of care for patients, such as the Hospital Patient’s Bill of Rights.

For too long, Maryland has been ranked the worst in the nation in hospital patient satisfaction, the longest in emergency room wait times, and below average in patient safety scores. We need a new regulatory agency that protects patients and promotes the laws that have been passed by our legislature to improve health care in Maryland.