By Steve Crane | Editor-in-chief
“One [benefit] is that the money can be brought outside of the nonprofit perimeter, so that accountability that we normally think of in a nonprofit, around things like executive spending, on travel, all that disappears because that’s kept down in the Caymans. The other reason that we see here is that the transactions are extremely difficult for tax enforcement authorities to identify, and so, effectively, reporting of a captive transaction is on the honor system.” - Jason Schupp, the whistleblower raising concerns about nonprofit hospitals’ use of offshore “captive” accounts for insurance purposes.
U
Maryland Insurance Commissioner Marie Grant sits on a panel to discuss insurance with Maryland legislators earlier this summer. (Photo by Danielle J. Brown/Maryland Matters)
By Danielle J. Brown
State officials are taking another close look at how Maryland’s nonprofit hospitals store billions of dollars in “captive insurance” companies domiciled in the Cayman Islands to determine if those funds should be subject to state taxes.
Hospital representatives, a national whistleblower and Maryland Insurance Administration officials met virtually this week in first public information gathering session on the question: How can Maryland officials ensure that nonprofit hospitals are not skirting state tax laws through the offshore insurance accounts?
It’s a question that state officials studied more than 10 years ago, but renewed attention to the potentially billions in untaxed that could be owed to the state came after a national whistleblower revived the issue during the 2026 session. Most hospitals believed they were not subject to the tax. But some other nonprofit organizations may have been paying that tax, raising questions on whether the insurance administration was enforcing the tax or might have been missing millions owed to the state.
Maryland ends the official 2026 heat season with a record-breaking 61 fatalities, though public health advocates warn that there's still time for another heat wave this year. (Photo by Staff Sgt. Sheila deVera/U.S. Air Force)
By Danielle J. Brown
The annual Maryland heat season ended with a record-breaking year for heat-related illnesses and deaths, with the state reporting that 61 Marylanders died due to hyperthermia in the season that ended Sept. 30.
It shattered the previous record of 42 fatalities, set in 2012, according to available public data, and came close to doubling last year’s 34 deaths, capping a troubling four-year rise in heat-related fatalities. This heat season also saw the highest number of calls to emergency medical services for heat-related illnesses in a year, at 1,657, up from last year's 1,634. The 1,603 visits to emergency department or urgent care this summer were down slightly from the record 1,670 set last year, according to the final data update for the 2026 heat season released Wednesday by the Maryland Department of Health.
Public health advocates say climate change is leading to longer heat waves and hotter temperatures during the summers, which puts more Marylanders at risk of heat exhaustion, heat stroke and death.
IN OTHER NEWS
U.S. measles cases top 4,000: U.S. measles cases for the year passed 4,000 for the first time in decades, with up to five Pennsylvania deaths, as the federal government steps in with financial help for states even as it fans vaccination fears and skepticism.
Vote on it, don’t bet on it: Prediction markets have become a flashpoint between states and feds as a host of states, including Maryland, struggle with the White House over who regulates the platforms and whether state laws banning election betting apply.
Cash 4 Homes!: The signs, mailers and texts promise cash, quick sales and a way to easily unload unwanted homes. But advocates say such wholesale home buying can confuse vulnerable homeowners and rob them of equity. And states are cracking down.
TODAY'S COMMENTARY
Maryland law has very specific rules for removing books from school library shelves, but that doesn't always stop a determined local school board, writes Sonia Kumar, which is why she says the fight against book banning begins with voting for our school boards.
MATTERS YOU MAY HAVE MISSED
Counsel on the defense: Maryland People's Counsel David Lapp, the state’s ratepayer advocate in utility regulatory cases, has to reapply for his job after it was posted by the attorney general, who says it's nothing personal, just the recommended hiring process.
‘Perfect storm’ for skilled trades: Immigration enforcement, aging journeymen and a data center building boom have combined to wreak havoc on the supply of skilled trade workers, leaving businesses scrambling for plumbers, electricians, carpenters and more.
Tariffs on the ballot: A growing number of voters are taking anger about affordability to the polls this election and blaming President Donald Trump’s tariffs for rising expenses, polls show. In Maryland, tariffs cost the average households another $2,732..
THE WEEK IN REVIEW
Thanks for reading Maryland Matters Memo. Did you know our daily morning newsletter is also free? Sign up here. And if you enjoyed today’s edition, please forward to a friend. Increasing our readership helps us cover more news.