Office of the Long-Term Care Ombudsman - Mandatory Appropriation
Summary
HB671 requires the Governor, beginning in fiscal year 2027, to include a mandatory appropriation in the annual budget bill for the Office of the Long-Term Care Ombudsman. The bill ties that funding to two revenue sources: at least 3% of the special funds collected from the Medicaid quality assessment imposed on certain nursing facilities, and at least $2 million from money remitted by managed care organizations under existing regulations, with a general fund backfill if those remittances fall short. The bill also specifies that these appropriations may not supplant existing funding for the Ombudsman office.
The measure amends the Health – General and Human Services Articles to carve out a portion of nursing facility assessment revenue that otherwise would be used for Medicaid nursing facility reimbursements, and to create a recurring budget requirement for the Ombudsman office in the Department of Aging. It does not change the core duties of the Ombudsman, but it strengthens the office’s funding stream and makes that support mandatory rather than discretionary. The bill takes effect July 1, 2026.
Impact
HB671 changes Maryland law by redirecting a defined share of Medicaid quality assessment revenues from nursing facility reimbursement to the Office of the Long-Term Care Ombudsman and by requiring a minimum annual appropriation from managed care organization remittances, with a general fund obligation if needed. It amends § 19-310.1 of the Health – General Article and § 10-903 of the Human Services Article, creating a new statutory funding floor for the Ombudsman office and limiting the extent to which those funds can replace existing appropriations. Nursing facilities, Medicaid financing, managed care organizations, and the Department of Aging are the primary affected parties.
Sentiment
The bill appears to have been broadly supported. It passed the House 126-2 and the Senate 44-0, indicating strong bipartisan approval and little recorded opposition. The favorable committee report and lack of recorded transcript debate suggest the measure was viewed as a targeted funding fix for a long-term care oversight function rather than a controversial policy change.
Contention
The main policy tension is fiscal: the bill diverts a portion of nursing facility assessment revenue away from Medicaid reimbursement and guarantees a minimum appropriation for the Ombudsman office, which could be seen as competing claims on limited special-fund and general-fund resources. Another possible point of concern is the use of managed care organization remittances and a general fund backstop to meet the $2 million floor, though no committee testimony is provided and the recorded votes show minimal opposition. The bill’s non-supplant language suggests lawmakers were attentive to preserving baseline funding while adding dedicated support.