A headline in the Notes From Annapolis...


A headline in the Notes From Annapolis column in yesterday's edition's of The Sun incorrectly referred to Medicare, when the story was about the state Medicaid program. The article also may incorrectly have led to the conclusion that doctors billing the state twice the amount they are now allowed to bill might actually get paid more. In fact, the higher billing to the state is designed to leverage a greater federal reimbursement to the state. The doctors' share of the reimbursement will not increase.

Medicare maneuver may be 'reprehensible,' but it passed anyhow

To one delegate, the bill promotes "unethical" behavior by physicians. She was one of three members of the Committee on Environmental Matters to vote "no."

To another delegate, the measure was "reprehensible." But he voted for it.

A third delegate said the bill was "a model already operating in other states."

And a fourth said it was a form of payback to the feds. He voted for it, too.

Three members of the committee abstained.

"This is the shell game," said Delegate Virginia M. Thomas, D-Howard, introducing the bill for last Friday's vote.

Widely used among legislators and bureaucrats here, the term refers to a scheme under which state government asks Maryland physicians to double their fees for the purposes of leveraging a larger federal Medicaid reimbursement. For a $20 doctor fee, the federal government now sends Maryland $10. The plan calls for setting the fee up to $40 -- thereby doubling the federal reimbursement.

Although the Congress apparently meant to prohibit this sort ofthing, the budget law it wrote last year kept the practice intact -- and legal. Several states, including Maryland, are taking advantage of the lapse.

Overall, the committee gave the bill a favorable, official vote of 17 infavor, three against and three abstentions.

Thus, several members explained, $110 million flimflammed -- legally -- from the federal government remains in the budget. No further program cuts were needed. No layoffs threatened. No taxes increased.

But almost no one, including those who held their noses to vote "yes," was happy.

"I find having to resort to this kind of financing policy pretty reprehensible," said Delegate Lawrence A. LaMotte, D-Baltimore County. Mr. LaMotte told the committee that federal regulators had advised him they will come down hard on Maryland as soon as they can.

"We are No. 1 on the hit list," he said. "We are spotlighted among all the states."

The state's dividend from this practice will be safe this fiscal year and for six months after that, Mr. LaMotte thinks. But thereafter, he said, in early 1992, reliance on the shell game could result in a budget deficit.

Delegate Alfred Redmer Jr., R-Baltimore County, called the bill"unethical" and "the wrong message."

Only Delegate Brian Frosh, D-Montgomery, spoke for the bill. He said he finds the ploy perfectly just. For years, he said, the federal government under President Ronald Reagan and President Bush has cut into health care for the poor or transferred the costs to states. He called the Maryland plan "perfectly legitimate."

But Delegate Rose Mary Bonsack, who is a physician as well as a Democratic representative from Harford County, disagreed.

"I feel it was unethical. I think physicians will find it a little hard to buy into."

Delegate Bonsack voted "no." She said she was aware that the state medical society had supported the bill. Nevertheless, she said, "From an ethical standpoint, I preferred to vote against it."


The ballots are in. The judges have made their choices. The accounting firm has tallied the results and it's now time to list the winners of the General Assembly's Gun Fight II: Quote of the Day competition.

Ladies and gentlemen, last Thursday's hearing before the Senate Judicial Proceedings Committee on legislation to ban the sale or transfer of semiautomatic assault weapons brought out some outstanding examples of rhetoric.

The first runner-up, who will fill in for the winning quote should the quote not be able to complete its term in office, goes to the female gun owner who told the committee:

"Up until I met my husband, I didn't know how to shoot."

The winner, despite almost being disqualified because it was spoken at a National Rifle Association rally rather than in the committee chambers, is -- a drum roll, please -- the man who claimed that the issue was a class struggle.

Gun-control proponents "drink champagne at country clubs. They're Biffs and Muffies who want to show their contempt for the Bubbas and Dora Jeans of this world, because Bubba and Dora Jean eat chili and shop at K mart," he said.


Inquiring minds want to know why members of the House Economic Matters Committee kept stealing away from a long hearing on health insurance bills Thursday afternoon, only to return sated and smiling.

A selfless investigation by one intrepid correspondent revealed a sumptuous spread of German food and beer in the committee staff room. The feast was sponsored by the Baltimore Brewing Co., a downtown Baltimore micro-brewery that wants to expand

into retailing and wholesaling. By a wacky coincidence, Economic Matters was scheduled to vote Saturday on a bill to allow the creation of the license the company needs.

Was the Baltimore Brewing Co. hosting a similar fete in the Senate Finance Committee, which is considering similar legislation?

"Not until they're ready to vote," said Theo de Groen, co-owner of the brewery.

Mr. de Groen provided all three varieties of the beer he brews: a dark beer, an amber and a lighter lager, which, incidentally, was surprisingly full-bodied without any bitter aftertaste.

You wouldn't expect us to expose such a scandal without checking the facts, would you?

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