HB 393
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
Third Reader
House Bill 393 (Delegate Barron, et al.)
Health and Government Operations Finance
Maryland Office of the Inspector General for Health
This bill renames the Office of the Inspector General (OIG) in the Maryland Department
of Health (MDH) to be the Maryland Office of the Inspector General for Health and
establishes it as an independent unit of the State. The bill specifies there is an
Inspector General (IG) position in the office, the IG’s appointment process, term limits,
and required qualifications. Funding and staff from the current OIG will transfer to the new
office. By December 1 annually, the office must submit a report to the Governor, specified
committees of the General Assembly, and the Secretary of Health on its activities during
the immediately preceding fiscal year, specified recoveries made by the office, a summary
of matters referred to prosecutive authorities and resulting prosecutions and convictions,
and any regulatory or statutory changes necessary to ensure compliance with applicable
federal and State law. The bill takes effect July 1, 2022.
Fiscal Summary
State Effect: The bill’s requirements can be handled with existing budgeted resources –
as necessary funding and positions are to be transferred from MDH. Revenues recovered
for MDH by the IG are not affected.
Local Effect: None.
Small Business Effect: None.
Analysis
Bill Summary: Subject to the advice and consent of the Senate, the Governor, the
Attorney General, and the State Treasurer must unanimously appoint the IG for a five-year
term, which begins July 1 after initial appointment. At the end of the term, the IG must
continue to serve until a successor is appointed. If a vacancy occurs in the office, an interim
IG must be appointed as successor to serve for the remainder of the unexpired term.
The IG must have professional experience or education in law, auditing, government
operations, financial management, or health policy. If the IG has a background in health policy,
professional experience or education in one of the other specified areas is also required.
To be eligible to be the IG, an individual must execute an affidavit stating that the
individual will not accept appointment to, or be a candidate for, a State or local office
during the period of service as the IG and for at least three years immediately after serving
as IG. Once in office, the IG must renew the affidavit every two years; failure to do so
subjects the IG to removal from office. Additionally, the IG may be removed unanimously
by the Governor, the Attorney General, and the State Treasurer for (1) misconduct in office;
(2) persistent failure to perform the duties of the office; or (3) conduct prejudicial to the
proper administration of justice.
The office must have access to specified services as provided by MDH, including
(1) information technology; (2) budget and finance; (3) human resources; (4) police;
(5) procurement; and (6) support services. In consultation with MDH, the office must
develop policies and adopt regulations regarding the use and confidentiality of these
services. The office must maintain a physical location within MDH and develop policies
and regulations regarding the use and confidentiality of the location of the office. Funding
for the office, including the IG’s salary, must be as provided in the State budget.
Uncodified language requires the Governor to transfer one position and $100,000 in
general funds and any related positions and funding for OIG as of July 1, 2022, from
M00A01.01 Executive Direction – Office of the Secretary for the Department of Health to
the Office of the Inspector General for Health.
Current Law: Chapter 70 of 2006 codified the existing OIG within MDH and authorized
the IG to investigate fraud, waste, and abuse of departmental funds. OIG must cooperate
and coordinate investigative efforts with the Medicaid Fraud Control Unit, departmental
programs, and other State and federal agencies to ensure a provider is not subject to
duplicative audits. The IG may take necessary steps to recover (1) mistaken claims paid or
payments obtained in error or fraudulent claims paid to or obtained by a provider and
(2) the cost of benefits mistakenly paid or obtained in error or fraudulently paid to or
obtained by a recipient.
Chapter 136 of 2016 authorized the IG to subpoena any person or evidence, administer
oaths, and take depositions and other testimony as part of an investigation of fraud, waste,
or abuse of departmental funds. The IG may use extrapolation during an audit to recover
HB 393/ Page 2
an overpayment from a provider. The IG may impose a civil money remedy against a
provider for a violation of State or federal law governing the conditions of payment for any
service or item for which the provider submitted a claim and received payment.
State Expenditures: The bill requires one staff position and $100,000 in general funds as
well as any related OIG funding and staff to transfer from MDH to the independent
Maryland Office of the Inspector General for Health. MDH advises that the office has
approximately 62 staff. This analysis assumes the one staff position and $100,000 will be
used to hire an assistant Attorney General necessary to support the new independent office.
MDH advises that at least three other (and as many as nine) additional positions are needed
to ensure that the new office is fully independent from MDH. However, as the bill requires
any related positions and funding to be transferred, any such additional positions are
assumed to be encompassed within those that must be transferred.
The bill also requires MDH to provide specified services to the new independent office.
Typically, the State’s health occupations boards and health regulatory commissions share
similar services, as provided by MDH, and reimburse the department accordingly. To the
extent that MDH requires the Office of the Inspector General for Health to pay for these
services, general fund expenditures increase correspondingly. Additionally, the bill
requires the new office to maintain a physical location within the department.
Additional Information
Prior Introductions: SB 963 of 2020 passed second reading in the Senate, but no further
action was taken. Its cross file, HB 609, passed in the House but received no further action
from the Senate Finance Committee.
Designated Cross File: SB 12 (Senator Hettleman) - Finance.
Information Source(s): Department of Budget and Management; Maryland Department
of Health; Maryland Insurance Administration; Department of Legislative Services
Fiscal Note History: First Reader - January 18, 2021
rh/jc Third Reader - February 12, 2021
Analysis by: Amberly Holcomb Direct Inquiries to:
(410) 946-5510
(301) 970-5510
HB 393/ Page 3


Statutes affected:
Text - First - Maryland Office of the Inspector General for Health: 2-501 Health General, 2-502 Health General, 2-502.1 Health General, 2-506 Health General
Text - Third - Maryland Office of the Inspector General for Health: 2-501 Health General, 2-502 Health General, 2-502.1 Health General, 2-506 Health General