LAWRENCE J. HOGAN, JR., Governor Ch. 251
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Chapter 251
(House Bill 971)
AN ACT concerning
Maryland Medical Assistance Program – Substance Abuse Use Disorder
Treatment – Network Adequacy
FOR the purpose of requiring the Maryland Department of Health and the Behavioral
Health Administration to ensure that the delivery system for specialty mental health
services for enrollees of managed care organizations has an adequate network of
providers available to provide alcohol and drug abuse substance use disorder
treatment for children under the age of 18 years; and generally relating to the
Maryland Medical Assistance Program and access to substance abuse use disorder
treatment services.
BY repealing and reenacting, with amendments,
Article – Health – General
Section 15–103(b)(21)
Annotated Code of Maryland
(2019 Replacement Volume and 2021 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
15–103.
(b) (21) (i) The Department shall establish a delivery system for specialty
mental health services for enrollees of managed care organizations.
(ii) The Behavioral Health Administration shall:
1. Design and monitor the delivery system;
2. Establish performance standards for providers in the
delivery system; and
3. Establish procedures to ensure appropriate and timely
referrals from managed care organizations to the delivery system that include:
A. Specification of the diagnoses and conditions eligible for
referral to the delivery system;
Ch. 251 2022 LAWS OF MARYLAND
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B. Training and clinical guidance in appropriate use of the
delivery system for managed care organization primary care providers;
C. Preauthorization by the utilization review agent of the
delivery system; and
D. Penalties for a pattern of improper referrals.
(iii) The Department shall collaborate with managed care
organizations to develop standards and guidelines for the provision of specialty mental
health services.
(iv) The delivery system shall:
1. Provide all specialty mental health services needed by
enrollees;
2. For enrollees who are dually diagnosed, coordinate the
provision of substance abuse USE DISORDER services provided by the managed care
organizations of the enrollees;
3. Consist of a network of qualified mental health
professionals from all core disciplines;
4. Include linkages with other public service systems; and
5. Comply with quality assurance, enrollee input, data
collection, and other requirements specified by the Department in regulation.
(v) The Department may contract with a managed care organization
for delivery of specialty mental health services if the managed care organization meets the
performance standards adopted by the Department in regulations.
(vi) The provisions of § 15–1005 of the Insurance Article apply to the
delivery system for specialty mental health services established under this paragraph and
administered by an administrative services organization.
(VII) THE DEPARTMENT AND THE BEHAVIORAL HEALTH
ADMINISTRATION SHALL ENSURE THAT THE DELI VERY SYSTEM HAS AN A DEQUATE
NETWORK OF PROVIDERS AVAILABLE TO PROVIDE ALCOHOL AND DRUG ABU SE
SUBSTANCE USE DISORDER TREATMENT FOR CHILDR EN UNDER THE AGE OF 18
YEARS.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October 1, 2022.
LAWRENCE J. HOGAN, JR., Governor Ch. 251
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SECTION 2. AND BE IT FURTHER ENACTED, That this Act is an emergency
measure, is necessary for the immediate preservation of the public health or safety, has been
passed by a yea and nay vote supported by three–fifths of all the members elected to each of
the two Houses of the General Assembly, and shall take effect from the date it is enacted.
Approved by the Governor, May 12, 2022.