EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0971*
HOUSE BILL 971
J1 2lr2913
By: Delegate Kipke
Introduced and read first time: February 10, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Maryland Medical Assistance Program – Substance Abuse Treatment – Network 2
Adequacy 3
FOR the purpose of requiring the Maryland Department of Health and the Behavioral 4
Health Administration to ensure that the delivery system for specialty mental health 5
services for enrollees of managed care organizations has an adequate network of 6
providers available to provide alcohol and drug abuse treatment for children under 7
the age of 18 years; and generally relating to the Maryland Medical Assistance 8
Program and access to substance abuse treatment services. 9
BY repealing and reenacting, with amendments, 10
Article – Health – General 11
Section 15–103(b)(21) 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2021 Supplement) 14
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 15
That the Laws of Maryland read as follows: 16
Article – Health – General 17
15–103. 18
(b) (21) (i) The Department shall establish a delivery system for specialty 19
mental health services for enrollees of managed care organizations. 20
(ii) The Behavioral Health Administration shall: 21
1. Design and monitor the delivery system; 22
2. Establish performance standards for providers in the 23 2 HOUSE BILL 971
delivery system; and 1
3. Establish procedures to ensure appropriate and timely 2
referrals from managed care organizations to the delivery system that include: 3
A. Specification of the diagnoses and conditions eligible for 4
referral to the delivery system; 5
B. Training and clinical guidance in appropriate use of the 6
delivery system for managed care organization primary care providers; 7
C. Preauthorization by the utilization review agent of the 8
delivery system; and 9
D. Penalties for a pattern of improper referrals. 10
(iii) The Department shall collaborate with managed care 11
organizations to develop standards and guidelines for the provision of specialty mental 12
health services. 13
(iv) The delivery system shall: 14
1. Provide all specialty mental health services needed by 15
enrollees; 16
2. For enrollees who are dually diagnosed, coordinate the 17
provision of substance abuse services provided by the managed care organizations of the 18
enrollees; 19
3. Consist of a network of qualified mental health 20
professionals from all core disciplines; 21
4. Include linkages with other public service systems; and 22
5. Comply with quality assurance, enrollee input, data 23
collection, and other requirements specified by the Department in regulation. 24
(v) The Department may contract with a managed care organization 25
for delivery of specialty mental health services if the managed care organization meets the 26
performance standards adopted by the Department in regulations. 27
(vi) The provisions of § 15–1005 of the Insurance Article apply to the 28
delivery system for specialty mental health services established under this paragraph and 29
administered by an administrative services organization. 30
(VII) THE DEPARTMENT AND THE BEHAVIORAL HEALTH 31
ADMINISTRATION SHALL ENSURE THAT THE DELIVERY SYSTEM HA S AN ADEQUATE 32 HOUSE BILL 971 3
NETWORK OF PROVIDERS AVAILABLE TO PROVIDE ALCOHOL A ND DRUG ABUSE 1
TREATMENT FOR CHILDREN UNDER THE AGE OF 18 YEARS. 2
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
October 1, 2022. 4