Maryland House Bill HB715

Maryland 2022 Regular Session

• Introduced: 1/31/22
• Refer: 1/31/22

Caption

Administrative Services Organizations – Requirements for Retraction, Repayment, or Mitigation of Claims

Impact

By requiring administrative services organizations to maintain and provide detailed claim histories and various forms related to claims processing, HB715 serves to protect healthcare providers, particularly those who have faced payment challenges due to processing issues. The bill mandates that organizations incur costs for independent audits under certain circumstances, emphasizing the intent to establish clearer and more just practices for handling claims. This legislative change is significant in promoting stability and trust within the legal and operational frameworks for mental health services in Maryland.

Summary

House Bill 715 introduces measures to regulate the practices of administrative services organizations that administer specialty mental health services under the Maryland Medical Assistance Program. The bill specifically prohibits these organizations from retracting, requiring repayment, or mitigating claims made by health care providers without providing necessary documentation. This aims to enhance transparency and accountability in the claims process for mental health services, ensuring that healthcare providers are treated fairly and can dispute claims without excessive administrative burdens.

Contention

The bill addresses potential conflicts within the existing systems where health care providers may face undue financial pressure due to retracted claims without proper justification or notice. Critics may argue regarding the potential financial burden placed on administrative services organizations due to the audit requirements, questioning if the balance between provider protection and organizational viability is adequately met. The two-year sunset provision included in the bill raises questions about its long-term effectiveness and the need for subsequent evaluation or amendment based on its initial implementation outcomes.