MD
Maryland House Bill HB1148

Maryland 2023 Regular Session

Maryland House Bill HB1148 Compare Versions

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1- WES MOORE, Governor Ch. 291
21
3-– 1 –
4-Chapter 291
5-(House Bill 1148)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *hb1148*
89
9-Behavioral Health Care – Treatment and Access
10-(Behavioral Health Model for Maryland)
10+HOUSE BILL 1148
11+J1, J3 3lr0459
12+ CF SB 582
13+By: Delegates Moon, Pena–Melnyk, Attar, Bagnall, Boyce, Charkoudian, Cullison,
14+Grossman, Guyton, Healey, Kelly, Lopez, McComas, Reznik, Shetty, Smith,
15+Solomon, Stein, Toles, Turner, and Wilkins Wilkins, Alston, Bhandari,
16+Chisholm, Guzzone, Hill, Hutchinson, S. Johnson, Kaiser, Kerr, R. Lewis,
17+Martinez, M. Morgan, Reilly, Rosenberg, Taveras, White, and Woods
18+Introduced and read first time: February 10, 2023
19+Assigned to: Health and Government Operations
20+Committee Report: Favorable with amendments
21+House action: Adopted
22+Read second time: March 10, 2023
1123
12-FOR the purpose of establishing the Commission on Behavioral Health Care Treatment
13-and Access to make recommendations to provide appropriate, accessible, and
14-comprehensive behavioral health services that are available on demand to
15-individuals in the State across the behavioral health continuum that are available
16-on demand; establishing the Behavioral Health Care Coordination Value–Based
17-Purchasing Pilot Program in the Maryland Department of Health to establish and
18-implement an intensive care coordination model using value–based purchasing in
19-the specialty behavioral health system; requiring, on or before a certain date, the
20-Department to submit a State plan amendment to the Centers for Medicare and
21-Medicaid Services to establish certified community behavioral health clinics apply
22-for certain federal planning grant funds; requiring the Department to apply to
23-participate in a certain demonstration program; extending to a certain date the
24-inclusion of certain audio–only telephone conversations in the definition of
25-“telehealth” in the Maryland Medical Assistance Program and certain requirements
26-related to the provision of reimbursement for health care services appropriately
27-provided through telehealth by the Program and certain insurers, nonprofit health
28-service plans, and health maintenance organizations; requiring the Maryland
29-Health Care Commission to study and make recommendations regarding the
30-delivery of health care services through telehealth, including payment parity for the
31-delivery of health care services through audiovisual and audio–only telehealth
32-technologies; and generally relating to behavioral health care treatment and access.
24+CHAPTER ______
3325
34-BY adding to
35- Article – Health – General
36-Section 13–4801 through 13–4807 to be under the new subtitle “Subtitle 48.
37-Commission on Behavioral Health Care Treatment and Access”; and 13–4901
38-through 13–4907 to be under the new subtitle “Subtitle 49. Behavioral Health
39-Care Coordination Value–Based Purchasing Pilot Program”; and 15–141.5
40- Annotated Code of Maryland
41- (2019 Replacement Volume and 2022 Supplement)
26+AN ACT concerning 1
4227
43-BY repealing and reenacting, with amendments,
44- Article – Health – General
45-Section 15–141.2
46- Annotated Code of Maryland
47- (2019 Replacement Volume and 2022 Supplement)
28+Behavioral Health Care – Treatment and Access 2
29+(Behavioral Health Model for Maryland) 3
4830
49-BY repealing and reenacting, with amendments, Ch. 291 2023 LAWS OF MARYLAND
31+FOR the purpose of establishing the Commission on Behavioral Health Care Treatment 4
32+and Access to make recommendations to provide appropriate, accessible, and 5
33+comprehensive behavioral health services that are available on demand to 6
34+individuals in the State across the behavioral health continuum that are available 7
35+on demand; establishing the Behavioral Health Care Coordination Value–Based 8
36+Purchasing Pilot Program in the Maryland Department of Health to establish and 9
37+implement an intensive care coordination model using value–based purchasing in 10
38+the specialty behavioral health system; requiring, on or before a certain date, the 11
39+Department to submit a State plan amendment to the Centers for Medicare and 12
40+Medicaid Services to establish certified community behavioral health clinics apply 13
41+for certain federal planning grant funds; requiring the Department to apply to 14
42+participate in a certain demonstration program; extending to a certain date the 15
43+inclusion of certain audio–only telephone conversations in the definition of 16
44+“telehealth” in the Maryland Medical Assistance Program and certain requirements 17
45+related to the provision of reimbursement for health care services appropriately 18
46+provided through telehealth by the Program and certain insurers, nonprofit health 19
47+service plans, and health maintenance organizations; requiring the Maryland 20
48+Health Care Commission to study and make recommendations regarding the 21 2 HOUSE BILL 1148
5049
51-– 2 –
52- Article – Insurance
53-Section 15–139
54- Annotated Code of Maryland
55- (2017 Replacement Volume and 2022 Supplement)
5650
57- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
58-That the Laws of Maryland read as follows:
51+delivery of health care services through telehealth, including payment parity for the 1
52+delivery of health care services through audiovisual and audio–only telehealth 2
53+technologies; and generally relating to behavioral health care treatment and access. 3
5954
60-Article – Health – General
55+BY adding to 4
56+ Article – Health – General 5
57+Section 13–4801 through 13–4807 to be under the new subtitle “Subtitle 48. 6
58+Commission on Behavioral Health Care Treatment and Access”; and 13–4901 7
59+through 13–4907 to be under the new subtitle “Subtitle 49. Behavioral Health 8
60+Care Coordination Value–Based Purchasing Pilot Program”; and 15–141.5 9
61+ Annotated Code of Maryland 10
62+ (2019 Replacement Volume and 2022 Supplement) 11
6163
62-SUBTITLE 48. COMMISSION ON BEHAVIORAL HEALTH CARE TREATMENT AND
63-ACCESS.
64+BY repealing and reenacting, with amendments, 12
65+ Article – Health – General 13
66+Section 15–141.2 14
67+ Annotated Code of Maryland 15
68+ (2019 Replacement Volume and 2022 Supplement) 16
6469
65-13–4801.
70+BY repealing and reenacting, with amendments, 17
71+ Article – Insurance 18
72+Section 15–139 19
73+ Annotated Code of Maryland 20
74+ (2017 Replacement Volume and 2022 Supplement) 21
6675
67- (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
68-INDICATED.
76+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 22
77+That the Laws of Maryland read as follows: 23
6978
70- (B) “BEHAVIORAL HEALTH ” INCLUDES SUBSTANCE–RELATED DISORDERS ,
71-ADDICTIVE DISORDERS , MENTAL DISORDERS , LIFE STRESSORS AND C RISES, AND
72-STRESS–RELATED PHYSICAL SYM PTOMS.
79+Article – Health – General 24
7380
74- (C) “COMMISSION” MEANS THE COMMISSION ON BEHAVIORAL HEALTH
75-CARE TREATMENT AND ACCESS.
81+SUBTITLE 48. COMMISSION ON BEHAVIORAL HEALTH CARE TREATMENT AND 25
82+ACCESS. 26
7683
77-13–4802.
84+13–4801. 27
7885
79- THERE IS A COMMISSION O N BEHAVIORAL HEALTH CARE TREATMENT AND
80-ACCESS.
86+ (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 28
87+INDICATED. 29
8188
82-13–4803.
89+ (B) “BEHAVIORAL HEALTH ” INCLUDES SUBSTANCE –RELATED DISORDERS , 30
90+ADDICTIVE DISORDERS, MENTAL DISORDERS , LIFE STRESSORS AND C RISES, AND 31
91+STRESS–RELATED PHYSICAL SYM PTOMS. 32
8392
84- (A) THE COMMISSION CONSISTS O F THE FOLLOWING MEMB ERS:
93+ (C) “COMMISSION” MEANS THE COMMISSION ON BEHAVIORAL HEALTH 33
94+CARE TREATMENT AND ACCESS. 34
8595
86- (1) ONE MEMBER OF THE SENATE OF MARYLAND, APPOINTED BY THE
87-PRESIDENT OF THE SENATE;
96+13–4802. 35 HOUSE BILL 1148 3
8897
89- (2) ONE MEMBER OF THE HOUSE OF DELEGATES, APPOINTED B Y THE
90-SPEAKER OF THE HOUSE;
9198
92- (3) ONE REPRESENTATIVE OF MARYLAND’S CONGRESSIONAL
93-DELEGATION;
9499
95- (4) THE SECRETARY OF HEALTH, OR THE SECRETARY’S DESIGNEE; WES MOORE, Governor Ch. 291
100+ THERE IS A COMMISSION ON BEHAVIORAL HEALTH CARE TREATMENT AND 1
101+ACCESS. 2
96102
97-– 3 –
103+13–4803. 3
98104
99- (5) THE SECRETARY OF HUMAN SERVICES, OR THE SECRETARY’S
100-DESIGNEE;
105+ (A) THE COMMISSION CONSISTS O F THE FOLLOWING MEMB ERS: 4
101106
102- (6) THE SECRETARY OF JUVENILE SERVICES, OR THE SECRETARY’S
103-DESIGNEE;
107+ (1) ONE MEMBER OF THE SENATE OF MARYLAND, APPOINTED BY THE 5
108+PRESIDENT OF THE SENATE; 6
104109
105- (7) THE DEPUTY SECRETARY FOR BEHAVIORAL HEALTH, OR THE
106-DEPUTY SECRETARY’S DESIGNEE;
110+ (2) ONE MEMBER OF THE HOUSE OF DELEGATES, APPOINTED BY THE 7
111+SPEAKER OF THE HOUSE; 8
107112
108- (8) THE MARYLAND INSURANCE COMMISSIONER , OR THE
109-COMMISSIONER ’S DESIGNEE;
113+ (3) ONE REPRESENTATIVE OF MARYLAND’S CONGRESSIONAL 9
114+DELEGATION; 10
110115
111- (9) THE EXECUTIVE DIRECTOR OF THE HEALTH SERVICES COST
112-REVIEW COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE;
116+ (4) THE SECRETARY OF HEALTH, OR THE SECRETARY’S DESIGNEE; 11
113117
114- (10) THE EXECUTIVE DIRECTOR OF THE MARYLAND HEALTH CARE
115-COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE;
118+ (5) THE SECRETARY OF HUMAN SERVICES, OR THE SECRETARY’S 12
119+DESIGNEE; 13
116120
117- (11) THE EXECUTIVE DIRECTOR OF THE MARYLAND COMMUNITY
118-HEALTH RESOURCES COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE;
121+ (6) THE SECRETARY OF JUVENILE SERVICES, OR THE SECRETARY’S 14
122+DESIGNEE; 15
119123
120- (12) THE EXECUTIVE DIRECTOR OF THE STATE–DESIGNATED HEALTH
121-INFORMATION EXCHANGE , OR THE EXECUTIVE DIRECTOR’S DESIGNEE;
124+ (7) THE DEPUTY SECRETARY FOR BEHAVIORAL HEALTH, OR THE 16
125+DEPUTY SECRETARY’S DESIGNEE; 17
122126
123- (13) THE EXECUTIVE DIRECTOR OF THE GOVERNOR’S OFFICE OF
124-CRIME PREVENTION, YOUTH, AND VICTIM SERVICES, OR THE EXECUTIVE
125-DIRECTOR’S DESIGNEE; AND
127+ (8) THE MARYLAND INSURANCE COMMISSIONER , OR THE 18
128+COMMISSIONER ’S DESIGNEE; 19
126129
127- (14) THE SECRETARY OF THE MARYLAND DEPARTMENT OF
128-DISABILITIES, OR THE SECRETARY’S DESIGNEE;
130+ (9) THE EXECUTIVE DIRECTOR OF THE HEALTH SERVICES COST 20
131+REVIEW COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE; 21
129132
130- (15) THE SECRETARY OF THE DEPARTMENT OF PUBLIC SAFETY AND
131-CORRECTIONAL SERVICES, OR THE SECRETARY’S DESIGNEE;
133+ (10) THE EXECUTIVE DIRECTOR OF THE MARYLAND HEALTH CARE 22
134+COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE; 23
132135
133- (16) THE SPECIAL SECRETARY OF OPIOID RESPONSE, OR THE
134-SPECIAL SECRETARY’S DESIGNEE; AND
136+ (11) THE EXECUTIVE DIRECTOR OF THE MARYLAND COMMUNITY 24
137+HEALTH RESOURCES COMMISSION, OR THE EXECUTIVE DIRECTOR’S DESIGNEE; 25
135138
136- (14) (17) THE FOLLOWING MEMBERS APPOINTED BY THE
137-GOVERNOR:
139+ (12) THE EXECUTIVE DIRECTOR OF THE STATE–DESIGNATED HEALTH 26
140+INFORMATION EXCHANGE , OR THE EXECUTIVE DIRECTOR’S DESIGNEE; 27
141+ 4 HOUSE BILL 1148
138142
139- (I) ONE REPRESENTATIVE OF THE MENTAL HEALTH
140-ASSOCIATION OF MARYLAND;
141- Ch. 291 2023 LAWS OF MARYLAND
142143
143-– 4 –
144- (II) ONE REPRESENTATIVE OF THE NATIONAL ALLIANCE ON
145-MENTAL ILLNESS;
144+ (13) THE EXECUTIVE DIRECTOR OF THE GOVERNOR’S OFFICE OF 1
145+CRIME PREVENTION, YOUTH, AND VICTIM SERVICES, OR THE EXECUTIVE 2
146+DIRECTOR’S DESIGNEE; AND 3
146147
147- (III) ONE REPRESENTATIVE OF THE COMMUNITY BEHAVIORAL
148-HEALTH ASSOCIATION OF MARYLAND;
148+ (14) THE SECRETARY OF THE MARYLAND DEPARTMENT OF 4
149+DISABILITIES, OR THE SECRETARY’S DESIGNEE; 5
149150
150- (IV) ONE REPRESENTATIVE OF A PROVIDER OF RESIDE NTIAL
151-BEHAVIORAL HEALTH SE RVICES;
151+ (15) THE SECRETARY OF THE DEPARTMENT OF PUBLIC SAFETY AND 6
152+CORRECTIONAL SERVICES, OR THE SECRETARY’S DESIGNEE; 7
152153
153- (V) ONE REPRESENTATIVE OF AN ACUTE CARE HOSPIT AL;
154+ (16) THE SPECIAL SECRETARY OF OPIOID RESPONSE, OR THE 8
155+SPECIAL SECRETARY’S DESIGNEE; AND 9
154156
155- (VI) ONE REPRESENTATIVE OF AN INPATIENT PSYCHIA TRIC
156-HOSPITAL;
157+ (14) (17) THE FOLLOWING MEMBERS APPOINTED BY THE 10
158+GOVERNOR: 11
157159
158- (VII) ONE INDIVIDUAL WITH E XPERIENCE AS A CONSU MER OF
159-BEHAVIORAL HEALTH SE RVICES;
160+ (I) ONE REPRESENTATIVE OF THE MENTAL HEALTH 12
161+ASSOCIATION OF MARYLAND; 13
160162
161- (VIII) ONE FAMILY MEMBER OF AN INDIVIDUAL WITH
162-EXPERIENCE AS A CONS UMER OF BEHAVIORAL H EALTH SERVICES ;
163+ (II) ONE REPRESENTATIVE OF THE NATIONAL ALLIANCE ON 14
164+MENTAL ILLNESS; 15
163165
164- (IX) ONE REPRESENTATIVE OF A PROVIDER OF SUBSTA NCE USE
165-TREATMENT SERVICES ;
166+ (III) ONE REPRESENTATIVE OF THE COMMUNITY BEHAVIORAL 16
167+HEALTH ASSOCIATION OF MARYLAND; 17
166168
167- (X) ONE REPRESENTATIVE OF A SCHOOL–BASED HEALTH
168-CENTER;
169+ (IV) ONE REPRESENTATIVE OF A PROVIDER OF RESIDE NTIAL 18
170+BEHAVIORAL HEALTH SE RVICES; 19
169171
170- (XI) ONE INDIVIDUAL WITH E XPERTISE IN SOCIAL
171-DETERMINANTS OF HEAL TH;
172+ (V) ONE REPRESENTATIVE OF AN ACUTE CARE HOSPIT AL; 20
172173
173- (XII) ONE INDIVIDUAL WITH E XPERTISE IN HEALTH E CONOMICS;
174+ (VI) ONE REPRESENTATIVE OF AN INPATIENT PSYCHIA TRIC 21
175+HOSPITAL; 22
174176
175- (XIII) ONE REPRESENTATIVE OF A HEALTH INSURANCE C ARRIER;
177+ (VII) ONE INDIVIDUAL WITH E XPERIENCE AS A CONSU MER OF 23
178+BEHAVIORAL HEALTH SE RVICES; 24
176179
177- (XIV) ONE REPRESENTATIVE OF A MANAGED CARE
178-ORGANIZATION ;
180+ (VIII) ONE FAMILY MEMBER OF AN INDIVIDUAL WITH 25
181+EXPERIENCE AS A CONS UMER OF BEHAVIORAL H EALTH SERVICES ; 26
179182
180- (XV) ONE REPRESENTATIVE FR OM THE OFFICE OF THE PUBLIC
181-DEFENDER;
183+ (IX) ONE REPRESENTATIVE OF A PROVIDER OF SUBSTA NCE USE 27
184+TREATMENT SERVICES ; 28
182185
183- (XVI) ONE REPRESENTATIVE OF THE DEVELOPMENTAL
184-DISABILITY COALITION;
186+ (X) ONE REPRESENTATIVE OF A SCHOOL–BASED HEALTH 29
187+CENTER; 30 HOUSE BILL 1148 5
185188
186- (XVII) ONE REPRESENTATIVE OF THE MARYLAND CHAPTER OF
187-THE NATIONAL COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE ; WES MOORE, Governor Ch. 291
188189
189-– 5 –
190190
191- (XVIII) ONE REPRESENTATIVE OF THE MARYLAND
192-PSYCHOLOGICAL ASSOCIATION; AND
191+ (XI) ONE INDIVIDUAL WITH E XPERTISE IN SOCIAL 1
192+DETERMINANTS OF HEAL TH; 2
193193
194- (XIX) ONE REPRESENTATIVE OF DISABILITY RIGHTS MARYLAND;
194+ (XII) ONE INDIVIDUAL WITH E XPERTISE IN HEALTH E CONOMICS; 3
195195
196- (XX) ONE REPRESENTATIVE OF A FEDERALLY QUALIFIED
197-HEALTH CENTER;
196+ (XIII) ONE REPRESENTATIVE OF A HEALTH INSURANCE C ARRIER; 4
198197
199- (XXI) ONE REPRESENTATIVE OF A LOCAL BEHAVIORAL HEALTH
200-AUTHORITY; AND
198+ (XIV) ONE REPRESENTATIVE OF A MANAGED CARE 5
199+ORGANIZATION ; 6
201200
202- (XXII) ONE INDIVIDUAL WITH A N INTELLECTUAL DISAB ILITY WHO
203-USES SELF–DIRECTED BEHAVIORAL HEALTH SERVICES .
201+ (XV) ONE REPRESENTATIVE FR OM THE OFFICE OF THE PUBLIC 7
202+DEFENDER; 8
204203
205- (B) TO THE EXTENT PRACTIC ABLE, THE MEMBERSHIP OF TH E COMMISSION
206-SHALL REFLECT THE GE OGRAPHIC AND ETHNIC DIVERSITY OF THE STATE.
204+ (XVI) ONE REPRESENTATIVE OF THE DEVELOPMENTAL 9
205+DISABILITY COALITION; 10
207206
208- (C) THE GOVERNOR, THE PRESIDENT OF THE SENATE, AND THE SPEAKER
209-OF THE HOUSE JOINTLY SHALL D ESIGNATE THE CHAIR O F THE COMMISSION.
207+ (XVII) ONE REPRESENTATIVE OF THE MARYLAND CHAPTER OF 11
208+THE NATIONAL COUNCIL ON ALCOHOLISM AND DRUG DEPENDENCE ; 12
210209
211- (D) THE DEPARTMENT SHALL PROV IDE STAFF FOR THE COMMISSION.
210+ (XVIII) ONE REPRESENTATIVE OF THE MARYLAND 13
211+PSYCHOLOGICAL ASSOCIATION; AND 14
212212
213- (E) A MEMBER OF THE COMMISSION:
213+ (XIX) ONE REPRESENTATIVE OF DISABILITY RIGHTS MARYLAND; 15
214214
215- (1) MAY NOT RECEIVE COMPENSATION AS A ME MBER OF THE
216-COMMISSION; BUT
215+ (XX) ONE REPRESENTATIVE OF A FEDERALLY QUALIFIED 16
216+HEALTH CENTER; 17
217217
218- (2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE
219-STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET .
218+ (XXI) ONE REPRESENTATIVE OF A LOCAL BEHAVIORAL HEALTH 18
219+AUTHORITY; AND 19
220220
221- (F) THE COMMISSION SHALL MEET AT LEAST THREE TIMES PER YEAR AT
222-THE TIMES AND PL ACES DETERMINED BY T HE COMMISSION.
221+ (XXII) ONE INDIVIDUAL WITH A N INTELLECTUAL DISAB ILITY WHO 20
222+USES SELF–DIRECTED BEHAVIORAL HEALTH SERVICES . 21
223223
224-13–4804.
224+ (B) TO THE EXTENT PRACTIC ABLE, THE MEMBERSHIP OF TH E COMMISSION 22
225+SHALL REFLECT THE GE OGRAPHIC AND ETHNIC DIVERSITY OF THE STATE. 23
225226
226- THE PURPOSE OF THE COMMISSION IS TO MAKE RECOMMENDATIONS TO
227-PROVIDE APPROPRIATE , ACCESSIBLE, AND COMPREHENSIVE BE HAVIORAL HEALTH
228-SERVICES THAT ARE AVAILABLE O N DEMAND TO INDIVIDUALS IN TH E STATE ACROSS
229-THE BEHAVIORAL HEALT H CONTINUUM THAT ARE AVAILABLE O N DEMAND.
227+ (C) THE GOVERNOR, THE PRESIDENT OF THE SENATE, AND THE SPEAKER 24
228+OF THE HOUSE JOINTLY SHALL D ESIGNATE THE CHAIR O F THE COMMISSION. 25
230229
231-13–4805.
230+ (D) THE DEPARTMENT SHALL PROV IDE STAFF FOR THE COMMISSION. 26
232231
233- THE COMMISSION SHALL : Ch. 291 2023 LAWS OF MARYLAND
232+ (E) A MEMBER OF THE COMMISSION: 27
233+ 6 HOUSE BILL 1148
234234
235-– 6 –
236235
237- (1) CONDUCT AN ASSESSMENT OF BEHAVIORAL HEALTH SERVICES IN
238-THE STATE TO IDENTIFY NEE DS AND GAPS IN SERVI CES ACROSS THE CON TINUUM,
239-INCLUDING COMMUNITY –BASED OUTPATIENT AND SUPPORT SERVICES , CRISIS
240-RESPONSE, AND INPATIENT CARE ;
236+ (1) MAY NOT RECEIVE COMPENSATION AS A ME MBER OF THE 1
237+COMMISSION; BUT 2
241238
242- (2) EXAMINE THE METHODS F OR REIMBURSING BEHAV IORAL
243-HEALTH CARE SERVICES IN THE STATE AND MAKE RECOMM ENDATIONS ON THE
244-MOST EFFECTIVE FORMS OF REIMBURS EMENT TO MAXIMIZE SE RVICE DELIVERY ;
239+ (2) IS ENTITLED TO REIMBU RSEMENT FOR EXPENSES UNDER THE 3
240+STANDARD STATE TRAVEL REGULATIONS, AS PROVIDED IN THE STATE BUDGET . 4
245241
246- (3) COMPILE FINDINGS OF STATE–SPECIFIC NEEDS ASSES SMENTS
247-RELATED TO BEHAVIORA L HEALTH CARE SERVIC ES;
242+ (F) THE COMMISSION SHALL MEET AT LEAST THREE TIMES PER YEAR AT 5
243+THE TIMES AND PL ACES DETERMINED BY T HE COMMISSION. 6
248244
249- (4) REVIEW RECOMMENDATION S AND REPORTS OF STATE
250-COMMISSIONS , WORKGROUPS , OR TASK FORCES RELAT ED TO BEHAVIORAL HEALTH
251-CARE SERVICES ;
245+13–4804. 7
252246
253- (5) CONDUCT A NEEDS ASSES SMENT ON THE STATE’S BEHAVIORAL
254-HEALTH CARE WORKFORC E TO IDENTIFY GAPS A ND MAKE RECOMMENDATI ONS TO
255-ENSURE AN ADEQUATE , CULTURALLY COMPETENT , AND DIVERSE WORKFORCE
256-ACROSS THE BEHAVIORA L HEALTH CARE CONTIN UUM;
247+ THE PURPOSE OF THE COMMISSION IS TO MAKE RECOMMENDATIONS TO 8
248+PROVIDE APPROPRIATE , ACCESSIBLE, AND COMPREHENSIVE BE HAVIORAL HEALTH 9
249+SERVICES THAT ARE AVAILABLE O N DEMAND TO INDIVIDUALS IN TH E STATE ACROSS 10
250+THE BEHAVIORAL HEALTH CONTI NUUM THAT ARE AVAILABLE O N DEMAND. 11
257251
258- (6) REVIEW TRENDS AND BES T PRACTICES FROM OTH ER STATES
259-REGARDING POLICY AND REIMBURSEMENT STRATE GIES THAT SUPPORT AC CESS TO
260-A COMPREHENSIVE ARRA Y OF SERVICES AND EN SURE QUALITY OF CARE ;
252+13–4805. 12
261253
262- (7) EXAMINE AND MAKE RECO MMENDATIONS RELATED TO THE
263-BEHAVIORAL HEALTH OF THE GERIAT RIC AND YOUTH POPULA TIONS IN THE STATE;
254+ THE COMMISSION SHALL : 13
264255
265- (8) EXAMINE AND MAKE RECO MMENDATIONS TO PROVI DE
266-APPROPRIATE AND ADEQ UATE BEHAVIORAL HEAL TH SERVICES TO INDIV IDUALS
267-WITH DEVELOPMENTAL DISABI LITIES AND COMPLEX BEHAVIORAL H EALTH NEEDS ,
268-SPECIFICALLY YOUTH;
256+ (1) CONDUCT AN ASSESSMENT OF BEHAVIORAL HEALTH SERVICES IN 14
257+THE STATE TO IDENTIFY NEE DS AND GAPS IN SERVI CES ACROSS THE CONTI NUUM, 15
258+INCLUDING COMMUNITY –BASED OUTPATIE NT AND SUPPORT SERVI CES, CRISIS 16
259+RESPONSE, AND INPATIENT CARE ; 17
269260
270- (9) ASSESS THE HEALTH INF RASTRUCTURE , FACILITIES,
271-PERSONNEL , AND SERVICES AVAILAB LE FOR THE STATE’S FORENSIC POPULATIO N
272-AND IDENTIFY DEFICIE NCIES IN RESOURCES A ND POLICIES NEEDED T O PRIORITIZE
273-HEALTH OUTCOMES , INCREASE PUBLIC SAFE TY, AND REDUCE RECIDIVISM ;
261+ (2) EXAMINE THE METHODS F OR REIMBURSING BEHAV IORAL 18
262+HEALTH CARE SERVICES IN THE STATE AND MAKE RECOMM ENDATIONS ON THE 19
263+MOST EFFECTIVE FORMS OF REIMBURSEMENT TO MAXIMIZE SERVICE DEL IVERY; 20
274264
275- (10) MAKE RECOMMENDATIONS ON EXPANDING BEHAVIO RAL HEALTH
276-TREATMENT ACCESS FOR THE STATE’S COURT–ORDERED POPULATION ;
277- WES MOORE, Governor Ch. 291
265+ (3) COMPILE FINDINGS OF STATE–SPECIFIC NEEDS ASSES SMENTS 21
266+RELATED TO BEHAVIORA L HEALTH CARE SERVIC ES; 22
278267
279-– 7 –
280- (11) MAKE RECOMMENDATIONS ON ACTION PLANS REGA RDING THE
281-BEHAVIORAL HEALTH CA RE SYSTEM’S CAPACITY TO PREPAR E FOR AND RESPOND TO
282-FUTURE CHALLENGES AF FECTING THE ENTIRE STATE OR PARTICULAR R EGIONS OR
283-POPULATIONS IN THE STATE, INCLUDING PANDEMICS AND EXTREME WEATHE R
284-EVENTS; AND
268+ (4) REVIEW RECOMMENDATION S AND REPORTS OF STATE 23
269+COMMISSIONS , WORKGROUPS , OR TASK FORCES RELAT ED TO BEHAVIORAL HEA LTH 24
270+CARE SERVICES ; 25
285271
286- (12) MAKE RECOMMENDATIONS TO ENSURE THAT BEHAV IORAL
287-HEALTH TREATMENT IS PROVIDED IN THE APPR OPRIATE SETTING , INCLUDING
288-METHODS TO DIVERT BE HAVIORAL HEALTH PATI ENTS FROM EMERGENCY
289-DEPARTMENTS BY USING THE MARYLAND MENTAL HEALTH AND SUBSTANCE USE
290-DISORDER REGISTRY AND REFERRAL SYSTEM ESTABLISHED UN DER § 7.5–802 OF
291-THIS ARTICLE AND 2–1–1;
272+ (5) CONDUCT A NEEDS ASSESSMENT ON THE STATE’S BEHAVIORAL 26
273+HEALTH CARE WORKFORC E TO IDENTIFY GAPS A ND MAKE RECOMMENDATI ONS TO 27
274+ENSURE AN ADEQUATE , CULTURALLY COMPETENT , AND DIVERSE WORKFORCE 28
275+ACROSS THE BEHAVIORA L HEALTH CARE CONTIN UUM; 29
292276
293- (13) EXAMINE AND REVIEW TH E USE OF HARM REDUCT ION
294-STRATEGIES TO FACILI TATE ACCESS TO CARE ; AND
277+ (6) REVIEW TRENDS AND BES T PRACTICES FROM OTHER STATES 30
278+REGARDING POLICY AND REIMBURSEMENT STRATE GIES THAT SUPPORT AC CESS TO 31
279+A COMPREHENSIVE ARRA Y OF SERVICES AND EN SURE QUALITY OF CARE ; 32 HOUSE BILL 1148 7
295280
296- (14) EXAMINE METHODS TO AS SIST CONSUMERS IN AC CESSING
297-BEHAVIORAL HEALTH SE RVICES.
298281
299-13–4806.
300282
301- (A) THE COMMISSION SHALL ESTA BLISH THE FOLLOWING WORKGROUPS :
283+ (7) EXAMINE AND MAKE RECO MMENDATIONS RELATED TO THE 1
284+BEHAVIORAL HEALTH OF THE GERIATRIC AND YO UTH POPULATIONS IN THE STATE; 2
302285
303- (1) GERIATRIC BEHAVIORAL HEALTH;
286+ (8) EXAMINE AND MAKE RECO MMENDATIONS TO PROVI DE 3
287+APPROPRIATE AND ADEQ UATE BEHAVIORAL HEAL TH SERVICES TO INDIV IDUALS 4
288+WITH DEVELOPMENTAL DISABI LITIES AND COMPLEX BEHAVIORAL H EALTH NEEDS , 5
289+SPECIFICALLY YOUTH ; 6
304290
305- (2) YOUTH BEHAVIORAL HEAL TH, INDIVIDUALS WITH
306-DEVELOPMENTAL DISABI LITIES, AND INDIVIDUALS WITH COMPLEX BEHAVIORAL
307-HEALTH NEEDS;
291+ (9) ASSESS THE HEALTH IN FRASTRUCTURE , FACILITIES, 7
292+PERSONNEL , AND SERVICES AVAILAB LE FOR THE STATE’S FORENSIC POPULATIO N 8
293+AND IDENTIFY DEFICIE NCIES IN RESOURCES A ND POLICIES NEEDED T O PRIORITIZE 9
294+HEALTH OUTCOMES , INCREASE PUBLIC SAFE TY, AND REDUCE RECIDIVIS M; 10
308295
309- (3) CRIMINAL JUSTICE –INVOLVED BEHAVIORAL HEALTH; AND
296+ (10) MAKE RECOMMENDA TIONS ON EXPANDING B EHAVIORAL HEALTH 11
297+TREATMENT ACCESS FOR THE STATE’S COURT–ORDERED POPULATION ; 12
310298
311- (4) BEHAVIORAL HEALTH WOR KFORCE DEVELOPMENT ,
312-INFRASTRUCTURE , COORDINATION , AND FINANCING .
299+ (11) MAKE RECOMMENDATIONS ON ACTION PLANS REGA RDING THE 13
300+BEHAVIORAL HEALTH CA RE SYSTEM’S CAPACITY TO PREPAR E FOR AND RESPOND TO 14
301+FUTURE CHALLENGES AF FECTING THE ENTIRE STATE OR PARTICULAR R EGIONS OR 15
302+POPULATIONS IN THE STATE, INCLUDING PANDEMICS AND EXTREME WEATHER 16
303+EVENTS; AND 17
313304
314- (B) THE WORKGROUPS ESTABL ISHED UNDER SUBSECTI ON (A) OF THIS
315-SECTION SHALL MEET A T LEAST TWO T IMES PER YEAR AT THE TIMES AND PLACES
316-DETERMINED BY THE WO RKGROUP.
305+ (12) MAKE RECOMMENDATIONS TO ENSURE THAT BEHAV IORAL 18
306+HEALTH TREATMENT IS PROVIDED IN THE APPR OPRIATE SETTING , INCLUDING 19
307+METHODS TO DIVER T BEHAVIORAL HEALTH PATIENTS FROM EMERGE NCY 20
308+DEPARTMENTS BY USING THE MARYLAND MENTAL HEALTH AND SUBSTANCE USE 21
309+DISORDER REGISTRY AND REFERRAL SYSTEM ESTABLISHED UN DER § 7.5–802 OF 22
310+THIS ARTICLE AND 2–1–1; 23
317311
318- (C) THE WORKGROUPS ESTABL ISHED UNDER SUBSECTI ON (A) OF THIS
319-SECTION SHALL INCLUD E MEMBERS OF THE COMMISSION AND MAY IN CLUDE
320-INDIVIDUALS INVITED BY THE COMMISSION TO SERVE O N THE WORKGROUP .
321- Ch. 291 2023 LAWS OF MARYLAND
312+ (13) EXAMINE AND REVIEW TH E USE OF HARM REDUCT ION 24
313+STRATEGIES TO FACILI TATE ACCESS TO CARE ; AND 25
322314
323-– 8 –
324- (D) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2023, THE
325-WORKGROUPS ESTABLISH ED UNDER SUBSECTION (A) OF THIS SECTION SHAL L
326-REPORT AND MAKE RECO MMENDATIONS TO THE COMMISSION.
315+ (14) EXAMINE METHODS TO AS SIST CONSUMERS IN AC CESSING 26
316+BEHAVIORAL HEALTH SE RVICES. 27
327317
328-13–4807.
318+13–4806. 28
329319
330- (A) (1) ON OR BEFORE JANUARY 1 EACH YEAR, BEGINNING IN 2024, THE
331-COMMISSION SHALL REPO RT TO THE GOVERNOR AND , IN ACCORDANCE WITH §
332-2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY ON THE
333-COMMISSION’S FINDINGS AND RECOM MENDATIONS , INCLUDING FUNDING AN D
334-LEGISLATIVE RECOMMEN DATIONS, THAT ARE CONSISTENT WITH PROVIDING
335-APPROPRIATE , ACCESSIBLE, AND COMPREHENSIVE BE HAVIORAL HEALTH SERV ICES
336-THAT ARE AVAILABLE O N DEMAND TO INDIVIDU ALS IN THE STATE ACROSS THE
337-BEHAVIORAL HEALTH CO NTINUUM.
320+ (A) THE COMMISSION SHALL ESTA BLISH THE FOLLOWING WORKGROUPS : 29
338321
339- (2) ANY LEGISLATIVE RECOM MENDATIONS INCLUDED IN THE
340-REPORT REQUIRED UNDE R PARAGRAPH (1) OF THIS SUBSECTION T HAT REQUIRE
341-FUNDING SHALL INCLUD E AN ESTIMATE OF THE FUNDING REQUIRED TO
342-IMPLEMENT THE RECOMM ENDATION AND INFORMA TION THAT SUPPORTS T HE
343-FUNDING ESTIMATE .
322+ (1) GERIATRIC BEHAVIORAL HEALTH; 30
323+ 8 HOUSE BILL 1148
344324
345- (B) THE REPORT REQUIRED O N OR BEFORE JANUARY 1, 2024, SHALL
346-INCLUDE THE FINDINGS OF THE NEEDS ASSESSMENTS RE QUIRED UNDER § 13–4805
347-OF THIS SUBTITLE.
348325
349- SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
350-as follows:
326+ (2) YOUTH BEHAVIORAL HEALTH , INDIVIDUALS WITH 1
327+DEVELOPMENTAL DISABI LITIES, AND INDIVIDUALS WITH COMPLEX BEHAVIORAL 2
328+HEALTH NEEDS ; 3
351329
352-Article – Health – General
330+ (3) CRIMINAL JUSTICE –INVOLVED BEHAVIORAL HEALTH; AND 4
353331
354-SUBTITLE 49. BEHAVIORAL HEALTH CARE COORDINATION VALUE–BASED
355-PURCHASING PILOT PROGRAM.
332+ (4) BEHAVIORAL HEALTH WOR KFORCE DEVELOPMENT , 5
333+INFRASTRUCTURE , COORDINATION , AND FINANCING. 6
356334
357-13–4901.
335+ (B) THE WORKGROUPS ESTABL ISHED UNDER SUBSECTI ON (A) OF THIS 7
336+SECTION SHALL MEET A T LEAST TWO TIMES PE R YEAR AT THE TIMES AND PLACES 8
337+DETERMINED BY THE WO RKGROUP. 9
358338
359- (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS
360-INDICATED.
339+ (C) THE WORKGROUPS ESTABL ISHED UNDER SUBSECTI ON (A) OF THIS 10
340+SECTION SHALL INCLUD E MEMBERS OF THE COMMISSION AND MAY IN CLUDE 11
341+INDIVIDUALS INVITED BY THE COMMISSION TO SERVE O N THE WORKGROUP . 12
361342
362- (B) “BEHAVIORAL HEALTH CAR E COORDINATION ” MEANS A
363-PERSON–CENTERED, TEAM–BASED ACTIVITY DESIG NED TO:
343+ (D) ON OR BEFORE DECEMBER 1 EACH YEAR, BEGINNING IN 2023, THE 13
344+WORKGROUPS ESTABLISH ED UNDER SUBSECTION (A) OF THIS SECTION SHAL L 14
345+REPORT AND MAKE RE COMMENDATIONS TO THE COMMISSION. 15
364346
365- (1) ASSESS AND MEET THE N EEDS OF AN INDIVID UAL WITH A
366-BEHAVIORAL HEALTH CO NDITION; AND
367- WES MOORE, Governor Ch. 291
347+13–4807. 16
368348
369-– 9 –
370- (2) HELP THE INDIVIDUAL N AVIGATE THE HEALTH C ARE SYSTEM
371-EFFECTIVELY AND EFFI CIENTLY.
349+ (A) (1) ON OR BEFORE JANUARY 1 EACH YEAR, BEGINNING IN 2024, THE 17
350+COMMISSION SHALL REPO RT TO THE GOVERNOR AND , IN ACCORDANCE WITH § 18
351+2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY ON THE 19
352+COMMISSION’S FINDINGS AND RECOMME NDATIONS, INCLUDING FUNDING AN D 20
353+LEGISLATIVE RECOMMEN DATIONS, THAT ARE CONSISTENT WITH PROVIDING 21
354+APPROPRIATE , ACCESSIBLE, AND COMPREHENSIVE BE HAVIORAL HEALTH SERV ICES 22
355+THAT ARE AVAILABLE O N DEMAND TO INDIVIDU ALS IN THE STATE ACROSS THE 23
356+BEHAVIORAL HEALTH CO NTINUUM. 24
372357
373- (C) “PILOT PROGRAM” MEANS THE BEHAVIORAL HEALTH CARE
374-COORDINATION VALUE–BASED PURCHASING PILOT PROGRAM.
358+ (2) ANY LEGISLATIVE RECOM MENDATIONS INCLUDED IN THE 25
359+REPORT REQUIRED UNDE R PARAGRAPH (1) OF THIS SUBSECTION T HAT REQUIRE 26
360+FUNDING SHALL INCLUD E AN ESTIMATE OF THE FUNDING REQUIRED TO 27
361+IMPLEMENT THE RECOMM ENDATION AND INFORMA TION THAT SUPPORTS THE 28
362+FUNDING ESTIMATE . 29
375363
376- (D) “VALUE–BASED PURCHASING ” MEANS FINANCIALLY IN CENTIVIZING
377-PROVIDERS TO MEET SP ECIFIED OUTCOME MEAS URES.
364+ (B) THE REPORT REQUIRED O N OR BEFORE JANUARY 1, 2024, SHALL 30
365+INCLUDE THE FINDINGS OF THE NEEDS ASSESSM ENTS REQUIRED UNDER § 13–4805 31
366+OF THIS SUBTITLE. 32
378367
379-13–4902.
368+ SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 33
369+as follows: 34 HOUSE BILL 1148 9
380370
381- THERE IS A BEHAVIORAL HEALTH CARE COORDINATION VALUE–BASED
382-PURCHASING PILOT PROGRAM IN THE DEPARTMENT .
383371
384-13–4903.
385372
386- THE PURPOSE OF THE PILOT PROGRAM IS TO ESTABLISH AND IMP LEMENT AN
387-INTENSIVE CARE COORD INATION MODEL USING VALUE–BASED PURCHASING IN THE
388-SPECIALTY BEHAVIORAL HEALTH SYSTEM .
373+Article – Health – General 1
389374
390-13–4904.
375+SUBTITLE 49. BEHAVIORAL HEALTH CARE COORDINATION VALUE–BASED 2
376+PURCHASING PILOT PROGRAM. 3
391377
392- (A) THE DEPARTMENT SHALL ADMI NISTER THE PILOT PROGRAM.
378+13–4901. 4
393379
394- (B) THE DEPARTMENT SHALL IDEN TIFY AT LEAST 500 ADULTS WHOSE
395-BEHAVIORAL HEALTH CO NDITION OR FUNCTIONI NG PLACES THEM AT RI SK OF
396-HOSPITAL EMERGENCY D EPARTMENT UTILIZATIO N OR INPATIENT PSYCH IATRIC
397-HOSPITAL ADMISSION .
380+ (A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 5
381+INDICATED. 6
398382
399- (C) THE PILOT PROGRAM SHALL BE OPER ATIONAL FOR A 3–YEAR PERIOD.
383+ (B) “BEHAVIORAL HEALTH CAR E COORDINATION ” MEANS A 7
384+PERSON–CENTERED, TEAM–BASED ACTIVITY DESIG NED TO: 8
400385
401- (D) A PROVIDER OR NETWORK OF PROVIDERS SELECTE D TO PARTICIPATE
402-IN THE PILOT PROGRAM SHALL :
386+ (1) ASSESS AND MEET THE N EEDS OF AN INDIVIDUA L WITH A 9
387+BEHAVIORAL HEALTH CO NDITION; AND 10
403388
404- (1) BE LICENSED AND IN GO OD STANDING WITH THE MARYLAND
405-MEDICAL ASSISTANCE PROGRAM;
389+ (2) HELP THE INDIVIDUAL N AVIGATE THE HEALTH C ARE SYSTEM 11
390+EFFECTIVEL Y AND EFFICIENTLY . 12
406391
407- (2) HAVE EXPERIENCE IN PR OVIDING COMMUNITY –BASED CARE
408-COORDINATION TO SPEC IALTY BEHAVIORAL HEA LTH PROGRAM RECIPIENTS ;
392+ (C) “PILOT PROGRAM” MEANS THE BEHAVIORAL HEALTH CARE 13
393+COORDINATION VALUE–BASED PURCHASING PILOT PROGRAM. 14
409394
410- (3) USE AN ELECTRONIC MED ICAL RECORD FOR DOCU MENTING CARE
411-COORDINATION ACTIVIT IES AND OUTCOMES COL LECTION; AND
412- Ch. 291 2023 LAWS OF MARYLAND
395+ (D) “VALUE–BASED PURCHASING ” MEANS FINANCIALLY IN CENTIVIZING 15
396+PROVIDERS TO MEET SP ECIFIED OUTCOME MEAS URES. 16
413397
414-– 10 –
415- (4) HAVE AN AUTOMATED DAT A EXCHANGE WITH THE
416-STATE–DESIGNATED HEALTH IN FORMATION EXCHANGE .
398+13–4902. 17
417399
418- (E) THE DEPARTMENT SHALL :
400+ THERE IS A BEHAVIORAL HEALTH CARE COORDINATION VALUE–BASED 18
401+PURCHASING PILOT PROGRAM IN THE DEPARTMENT . 19
419402
420- (1) PROVIDE REIMBURSEMENT ON A PER MEMBER PER MONTH BASIS
421-FOR THE BEHAVIORAL H EALTH CARE COORDINAT ION ACTIVITIES THAT ARE NOT
422-OTHERWISE COVERED BY THE MARYLAND MEDICAL ASSISTANCE PROGRAM;
403+13–4903. 20
423404
424- (2) COLLECT OUTCOMES DATA ON RECIPIENTS OF HEA LTH CARE
425-SERVICES UNDER THE PILOT PROGRAM; AND
405+ THE PURPOSE OF THE PILOT PROGRAM IS TO ESTABLI SH AND IMPLEMENT AN 21
406+INTENSIVE CARE COORD INATION MODEL USING VALUE–BASED PURCHASING IN THE 22
407+SPECIALTY BEHAVIORAL HEALTH SY STEM. 23
426408
427- (3) EVALUATE THE EFFECTIV ENESS OF THE VALUE –BASED
428-PURCHASING MODEL BY ANALYZING THE FOLLOW ING OUTCOME MEASURES :
409+13–4904. 24
429410
430- (I) A COMPARISON OF THE FO LLOWING DATA ELEMENT S
431-BEFORE AND AFTER ENR OLLMENT OF RECIPIENT S OF HEALTH CARE SER VICES
432-UNDER THE PILOT PROGRAM:
411+ (A) THE DEPARTMENT SHALL ADMI NISTER THE PILOT PROGRAM. 25
433412
434- 1. EMERGENCY DEPARTMENT UTILIZATION FOR BOTH
435-BEHAVIORAL AND SOMAT IC HEALTH PURPOSES ;
413+ (B) THE DEPARTMENT SHALL IDEN TIFY AT LEAST 500 ADULTS WHOSE 26
414+BEHAVIORAL HEALTH CO NDITION OR FUNCTIONI NG PLACES THEM AT RI SK OF 27
415+HOSPITAL EMERGENCY D EPARTMENT UTILIZATION OR INPAT IENT PSYCHIATRIC 28
416+HOSPITAL ADMISSION . 29 10 HOUSE BILL 1148
436417
437- 2. INPATIENT HOSPITALIZA TION FOR BOTH
438-BEHAVIORAL AND SOMAT IC HEALTH PURPOSES ; AND
439418
440- 3. TOTAL HEALTH CARE EXP ENDITURES;
441419
442- (II) OUTCOMES FOR RECIPIEN TS WITH AND WITHOUT PRIMARY
443-CARE SERVICES COORDI NATED BY A BEHAVIORA L HEALTH PROVIDER ; AND
420+ (C) THE PILOT PROGRAM SHALL BE OPER ATIONAL FOR A 3–YEAR PERIOD. 1
444421
445- (III) RECOGNIZED CLINICAL Q UALITY METRICS WHICH MAY
446-INCLUDE PATIENT EXPE RIENCE MEASURES .
422+ (D) A PROVIDER OR NETWORK OF PROVIDERS SELECTE D TO PARTICIPATE 2
423+IN THE PILOT PROGRAM SHALL : 3
447424
448-13–4905.
425+ (1) BE LICENSED AND IN GO OD STANDING WITH THE MARYLAND 4
426+MEDICAL ASSISTANCE PROGRAM; 5
449427
450- IF NECESSARY TO IMPLE MENT THE PILOT PROGRAM, THE DEPARTMENT
451-SHALL APPLY TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR AN
452-AMENDMENT TO THE STATE’S § 1115 HEALTHCHOICE DEMONSTRATION .
428+ (2) HAVE EXPERIENCE IN PR OVIDING COMMUNITY –BASED CARE 6
429+COORDINATION TO SPEC IALTY BEHAVIORAL HEA LTH PROGRAM RECIPIEN TS; 7
453430
454-13–4906.
431+ (3) USE AN ELECTRONIC MED ICAL RECORD FOR DOCU MENTING CARE 8
432+COORDINATION ACTIVIT IES AND OUTCOMES COLLECTION ; AND 9
455433
456- (A) FOR EACH OF FISCAL YE AR 2025, FISCAL YEAR 2026, AND FISCAL YEAR
457-2027, THE GOVERNOR SHAL L INCLUDE IN THE ANN UAL BUDGET BILL AN
458-APPROPRIATION OF $600,000 FOR THE PILOT PROGRAM. WES MOORE, Governor Ch. 291
434+ (4) HAVE AN AUTOMATED DAT A EXCHANGE WITH THE 10
435+STATE–DESIGNATED HEALTH IN FORMATION EXCHANGE . 11
459436
460-– 11 –
437+ (E) THE DEPARTMENT SHALL : 12
461438
462- (B) BEGINNING IN FISCAL Y EAR 2026, THE DEPARTMENT SHALL ALLO CATE
463-A PERCENTAGE OF THE ANNUAL APPROPRIATION REQUIRED UNDER SUBSE CTION
464-(A) OF THIS SECTION TO REIMBURSEMENT PAID B ASED ON THE ACHIEVEM ENT OF
465-THE OUTCOME MEASURES DESCRIBED IN § 13–4904(E)(3) OF THIS SUBTITLE.
439+ (1) PROVIDE REIMBURSEMENT ON A PER MEMBER PER MONTH BASIS 13
440+FOR THE BEHAVIORAL H EALTH CARE COORDINAT ION ACTIVITIES THAT ARE NOT 14
441+OTHERWISE COVERED BY THE MARYLAND MEDICAL ASSISTANCE PROGRAM; 15
466442
467- (C) IN FISCAL YEAR 2027, THE DEPARTMENT SHALL INCR EASE THE
468-PERCENTAGE OF THE AN NUAL APPROPRIATION R EQUIRED UNDER SUBSEC TION (A)
469-OF THIS SECTION ALLOCATED TO RE IMBURSEMENT PAID IN ACCORDANCE WITH
470-SUBSECTION (B) OF THIS SECTION OVER THE PERCENTAGE ALLOC ATED IN FISCAL
471-YEAR 2026.
443+ (2) COLLECT OUTCOMES DATA ON RECIPIENTS OF HEA LTH CARE 16
444+SERVICES UNDER THE PILOT PROGRAM; AND 17
472445
473-13–4907.
446+ (3) EVALUATE THE EFFECTIV ENESS OF THE VALUE –BASED 18
447+PURCHASING MODEL BY ANALYZING THE FOLLOWING OUTCOME MEASURES : 19
474448
475- ON OR BEFORE NOVEMBER 1, 2027, THE DEPARTMENT SHALL REPO RT TO
476-THE GOVERNOR AND , IN ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT
477-ARTICLE, THE GENERAL ASSEMBLY ON THE DEPARTMENT ’S FINDINGS AND
478-RECOMMENDATIONS FROM THE PILOT PROGRAM.
449+ (I) A COMPARISON OF THE FO LLOWING DATA ELEMENT S 20
450+BEFORE AND AFTER ENR OLLMENT OF RECIPIENT S OF HEALTH CARE SER VICES 21
451+UNDER THE PILOT PROGRAM: 22
479452
480- SECTION 3. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
481-as follows:
453+ 1. EMERGENCY DEPARTMENT UTILIZATION FOR BOTH 23
454+BEHAVIORAL AND SOMAT IC HEALTH PURPOSES ; 24
482455
483-Article – Health – General
456+ 2. INPATIENT HOSPITALIZA TION FOR BOTH 25
457+BEHAVIORAL AND SOMAT IC HEALTH PURPOSES ; AND 26
484458
485-15–141.2.
459+ 3. TOTAL HEALTH CARE EXP ENDITURES; 27
486460
487- (a) (1) In this section the following words have the meanings indicated.
461+ (II) OUTCOMES FOR RECIPIEN TS WITH AND WITHOUT PRIMARY 28
462+CARE SERVICES COORDI NATED BY A BEHAVIORA L HEALTH PROVI DER; AND 29
463+ HOUSE BILL 1148 11
488464
489- (2) “Distant site” means a site at which the distant site health care provider
490-is located at the time the health care service is provided through telehealth.
491465
492- (3) “Distant site provider” means the health care provider who provides
493-medically necessary services to a patient at an originating site from a different physical
494-location than the location of the patient.
466+ (III) RECOGNIZED CLINICAL Q UALITY METRICS WHICH MAY 1
467+INCLUDE PATIENT EXPE RIENCE MEASURES . 2
495468
496- (4) “Health care provider” means:
469+13–4905. 3
497470
498- (i) A person who is licensed, certified, or otherwise authorized under
499-the Health Occupations Article to provide health care in the ordinary course of business or
500-practice of a profession or in an approved education or training program;
471+ IF NECESSARY TO IMPLE MENT THE PILOT PROGRAM, THE DEPARTMENT 4
472+SHALL APPLY TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR AN 5
473+AMENDMENT TO THE STATE’S § 1115 HEALTHCHOICE DEMONSTRATION . 6
501474
502- (ii) A mental health and substance use disorder program licensed in
503-accordance with § 7.5–401 of this article;
504- Ch. 291 2023 LAWS OF MARYLAND
475+13–4906. 7
505476
506-– 12 –
507- (iii) A person licensed under Title 7, Subtitle 9 of this article to
508-provide services to an individual with developmental disability or a recipient of individual
509-support services; or
477+ (A) FOR EACH OF FISCAL YE AR 2025, FISCAL YEAR 2026, AND FISCAL YEAR 8
478+2027, THE GOVERNOR SHALL INCLUD E IN THE ANNUAL BUDG ET BILL AN 9
479+APPROPRIATION OF $600,000 FOR THE PILOT PROGRAM. 10
510480
511- (iv) A provider as defined under § 16–201.4 of this article to provide
512-services to an individual receiving long–term care services.
481+ (B) BEGINNING IN FISCAL YEAR 2026, THE DEPARTMENT SHALL ALLO CATE 11
482+A PERCENTAGE OF THE ANNUAL APPROPRIATION REQUIRED UNDER SUBSE CTION 12
483+(A) OF THIS SECTION TO R EIMBURSEMENT PAID BA SED ON THE ACHIEVEME NT OF 13
484+THE OUTCOME MEASURES DESCRIBED IN § 13–4904(E)(3) OF THIS SUBTITLE. 14
513485
514- (5) “Originating site” means the location of the Program recipient at the
515-time the health care service is provided through telehealth.
486+ (C) IN FISCAL YEAR 2027, THE DEPARTMENT SHALL INCR EASE THE 15
487+PERCENTAGE OF THE AN NUAL APPROPRIATION R EQUIRED UNDER SUBSEC TION (A) 16
488+OF THIS SECTION ALLO CATED TO REIMBURSEME NT PAID IN ACCORDANC E WITH 17
489+SUBSECTION (B) OF THIS SECTION OVER THE PERCENTAGE ALLOC ATED IN FISCAL 18
490+YEAR 2026. 19
516491
517- (6) “Remote patient monitoring services” means the use of synchronous or
518-asynchronous digital technologies that collect or monitor medical, patient–reported, and
519-other forms of health care data for Program recipients at an originating site and
520-electronically transmit that data to a distant site provider to enable the distant site
521-provider to assess, diagnose, consult, treat, educate, provide care management, suggest
522-self–management, or make recommendations regarding the Program recipient’s health
523-care.
492+13–4907. 20
524493
525- (7) (i) “Telehealth” means the delivery of medically necessary somatic,
526-dental, or behavioral health services to a patient at an originating site by a distant site
527-provider through the use of technology–assisted communication.
494+ ON OR BEFORE NOVEMBER 1, 2027, THE DEPARTMENT SHALL REPO RT TO 21
495+THE GOVERNOR AND , IN ACCORDANCE WITH § 2–1257 OF THE STATE GOVERNMENT 22
496+ARTICLE, THE GENERAL ASSEMBLY ON THE DEPARTMENT ’S FINDINGS AND 23
497+RECOMMENDATIONS FROM THE PILOT PROGRAM. 24
528498
529- (ii) “Telehealth” includes:
499+ SECTION 3. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 25
500+as follows: 26
530501
531- 1. Synchronous and asynchronous interactions;
502+Article – Health – General 27
532503
533- 2. From July 1, 2021, to June 30, [2023] 2025, both
534-inclusive, an audio–only telephone conversation between a health care provider and a
535-patient that results in the delivery of a billable, covered health care service; and
504+15–141.2. 28
536505
537- 3. Remote patient monitoring services.
506+ (a) (1) In this section the following words have the meanings indicated. 29
538507
539- (iii) “Telehealth” does not include the provision of health care
540-services solely through:
508+ (2) “Distant site” means a site at which the distant site health care provider 30
509+is located at the time the health care service is provided through telehealth. 31
510+ 12 HOUSE BILL 1148
541511
542- 1. Except as provided in subparagraph (ii)2 of this
543-paragraph, an audio–only telephone conversation;
544512
545- 2. An e–mail message; or
513+ (3) “Distant site provider” means the health care provider who provides 1
514+medically necessary services to a patient at an originating site from a different physical 2
515+location than the location of the patient. 3
546516
547- 3. A facsimile transmission.
517+ (4) “Health care provider” means: 4
548518
549- (b) The Program shall:
550- WES MOORE, Governor Ch. 291
519+ (i) A person who is licensed, certified, or otherwise authorized under 5
520+the Health Occupations Article to provide health care in the ordinary course of business or 6
521+practice of a profession or in an approved education or training program; 7
551522
552-– 13 –
553- (1) Provide health care services appropriately delivered through telehealth
554-to Program recipients regardless of the location of the Program recipient at the time
555-telehealth services are provided; and
523+ (ii) A mental health and substance use disorder program licensed in 8
524+accordance with § 7.5–401 of this article; 9
556525
557- (2) Allow a distant site provider to provide health care services to a
558-Program recipient from any location at which the health care services may be appropriately
559-delivered through telehealth.
526+ (iii) A person licensed under Title 7, Subtitle 9 of this article to 10
527+provide services to an individual with developmental disability or a recipient of individual 11
528+support services; or 12
560529
561- (c) The services required to be provided under subsection (b) of this section shall
562-include counseling and treatment for substance use disorders and mental health conditions.
530+ (iv) A provider as defined under § 16–201.4 of this article to provide 13
531+services to an individual receiving long–term care services. 14
563532
564- (d) The Program may not:
533+ (5) “Originating site” means the location of the Program recipient at the 15
534+time the health care service is provided through telehealth. 16
565535
566- (1) Exclude from coverage a health care service solely because it is provided
567-through telehealth and is not provided through an in–person consultation or contact
568-between a health care provider and a patient; or
536+ (6) “Remote patient monitoring services” means the use of synchronous or 17
537+asynchronous digital technologies that collect or monitor medical, patient–reported, and 18
538+other forms of health care data for Program recipients at an originating site and 19
539+electronically transmit that data to a distant site provider to enable the distant site 20
540+provider to assess, diagnose, consult, treat, educate, provide care management, suggest 21
541+self–management, or make recommendations regarding the Program recipient’s health 22
542+care. 23
569543
570- (2) Exclude from coverage a behavioral health care service provided to a
571-Program recipient in person solely because the service may also be provided through
572-telehealth.
544+ (7) (i) “Telehealth” means the delivery of medically necessary somatic, 24
545+dental, or behavioral health services to a patient at an originating site by a distant site 25
546+provider through the use of technology–assisted communication. 26
573547
574- (e) The Program may undertake utilization review, including preauthorization,
575-to determine the appropriateness of any health care service whether the service is delivered
576-through an in–person consultation or through telehealth if the appropriateness of the
577-health care service is determined in the same manner.
548+ (ii) “Telehealth” includes: 27
578549
579- (f) The Program may not distinguish between Program recipients in rural or
580-urban locations in providing coverage under the Program for health care services delivered
581-through telehealth.
550+ 1. Synchronous and asynchronous interactions; 28
582551
583- (g) (1) Subject to paragraph (3) of this subsection, the Program shall
584-reimburse a health care provider for the diagnosis, consultation, and treatment of a
585-Program recipient for a health care service covered by the Program that can be
586-appropriately provided through telehealth.
552+ 2. From July 1, 2021, to June 30, [2023] 2025, both 29
553+inclusive, an audio–only telephone conversation between a health care provider and a 30
554+patient that results in the delivery of a billable, covered health care service; and 31
587555
588- (2) This subsection does not require the Program to reimburse a health
589-care provider for a health care service delivered in person or through telehealth that is:
556+ 3. Remote patient monitoring services. 32
590557
591- (i) Not a covered health care service under the Program; or
558+ (iii) “Telehealth” does not include the provision of health care 33
559+services solely through: 34 HOUSE BILL 1148 13
592560
593- (ii) Delivered by an out–of–network provider unless the health care
594-service is a self–referred service authorized under the Program.
595561
596- (3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when
597-appropriately provided through telehealth, the Program shall provide reimbursement in Ch. 291 2023 LAWS OF MARYLAND
598562
599-– 14 –
600-accordance with paragraph (1) of this subsection on the same basis and the same rate as if
601-the health care service were delivered by the health care provider in person.
563+ 1. Except as provided in subparagraph (ii)2 of this 1
564+paragraph, an audio–only telephone conversation; 2
602565
603- (ii) The reimbursement required under subparagraph (i) of this
604-paragraph does not include:
566+ 2. An e–mail message; or 3
605567
606- 1. Clinic facility fees unless the health care service is
607-provided by a health care provider not authorized to bill a professional fee separately for
608-the health care service; or
568+ 3. A facsimile transmission. 4
609569
610- 2. Any room and board fees.
570+ (b) The Program shall: 5
611571
612- (h) (1) The Department may specify in regulation the types of health care
613-providers eligible to receive reimbursement for health care services provided to Program
614-recipients under this section.
572+ (1) Provide health care services appropriately delivered through telehealth 6
573+to Program recipients regardless of the location of the Program recipient at the time 7
574+telehealth services are provided; and 8
615575
616- (2) If the Department specifies by regulation the types of health care
617-providers eligible to receive reimbursement for health care services provided to Program
618-recipients under this subsection, the regulations shall include all types of health care
619-providers that appropriately provide telehealth services.
576+ (2) Allow a distant site provider to provide health care services to a 9
577+Program recipient from any location at which the health care services may be appropriately 10
578+delivered through telehealth. 11
620579
621- (3) For the purpose of reimbursement and any fidelity standards
622-established by the Department, a health care service provided through telehealth is
623-equivalent to the same health care service when provided through an in –person
624-consultation.
580+ (c) The services required to be provided under subsection (b) of this section shall 12
581+include counseling and treatment for substance use disorders and mental health conditions. 13
625582
626- (i) Subject to subsection (g)(2) of this section, the Program or a managed care
627-organization that participates in the Program may not impose as a condition of
628-reimbursement of a covered health care service delivered through telehealth that the
629-health care service be provided by a third–party vendor designated by the Program.
583+ (d) The Program may not: 14
630584
631- (j) The Department may adopt regulations to carry out this section.
585+ (1) Exclude from coverage a health care service solely because it is provided 15
586+through telehealth and is not provided through an in–person consultation or contact 16
587+between a health care provider and a patient; or 17
632588
633- (k) The Department shall obtain any federal authority necessary to implement
634-the requirements of this section, including applying to the Centers for Medicare and
635-Medicaid Services for an amendment to any of the State’s § 1115 waivers or the State plan.
589+ (2) Exclude from coverage a behavioral health care service provided to a 18
590+Program recipient in person solely because the service may also be provided through 19
591+telehealth. 20
636592
637- (l) This section may not be construed to supersede the authority of the Health
638-Services Cost Review Commission to set the appropriate rates for hospitals, including
639-setting the hospital facility fee for hospital–provided telehealth.
593+ (e) The Program may undertake utilization review, including preauthorization, 21
594+to determine the appropriateness of any health care service whether the service is delivered 22
595+through an in–person consultation or through telehealth if the appropriateness of the 23
596+health care service is determined in the same manner. 24
640597
641-15–141.5.
598+ (f) The Program may not distinguish between Program recipients in rural or 25
599+urban locations in providing coverage under the Program for health care services delivered 26
600+through telehealth. 27
642601
643- (A) IN THIS SECTION , “CERTIFIED COMMUNITY BEHAVIORAL HEALTH
644-CLINIC” MEANS A NONPROFIT CO MPREHENSIVE COMMUNIT Y MENTAL HEALTH OR
645-SUBSTANCE USE TREATM ENT ORGANIZATION LIC ENSED BY THE STATE THAT MEETS WES MOORE, Governor Ch. 291
602+ (g) (1) Subject to paragraph (3) of this subsection, the Program shall 28
603+reimburse a health care provider for the diagnosis, consultation, and treatment of a 29
604+Program recipient for a health care service covered by the Program that can be 30
605+appropriately provided through telehealth. 31
646606
647-– 15 –
648-THE FEDERAL CERTIFIC ATION CRITERIA OF § 223 OF THE FEDERAL PROTECTING
649-ACCESS TO MEDICARE ACT OF 2014 AND OFFERS , DIRECTLY OR INDIRECT LY
650-THROUGH FORMAL REFER RAL RELATIONSHIPS WI TH OTHER PROVIDERS , THE
651-FOLLOWING SERVICES :
607+ (2) This subsection does not require the Program to reimburse a health 32
608+care provider for a health care service delivered in person or through telehealth that is: 33 14 HOUSE BILL 1148
652609
653- (1) OUTPATIENT MENTAL HEA LTH AND SUBSTANCE US E SERVICES;
654610
655- (2) 24–HOUR MOBILE CRISIS R ESPONSE AND HOTLINE SERVICES;
656611
657- (3) SCREENING, ASSESSMENT, AND DIAGNOSIS , INCLUDING RISK
658-ASSESSMENTS ;
612+ (i) Not a covered health care service under the Program; or 1
659613
660- (4) PERSON–CENTERED TREATMENT P LANNING;
614+ (ii) Delivered by an out–of–network provider unless the health care 2
615+service is a self–referred service authorized under the Program. 3
661616
662- (5) PRIMARY CARE SCREENIN G AND MONITORING OF KEY
663-INDICATORS OF HEALTH RISKS;
617+ (3) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 4
618+appropriately provided through telehealth, the Program shall provide reimbursement in 5
619+accordance with paragraph (1) of this subsection on the same basis and the same rate as if 6
620+the health care service were delivered by the health care provider in person. 7
664621
665- (6) TARGETED CASE MANAGEM ENT;
622+ (ii) The reimbursement required under subparagraph (i) of this 8
623+paragraph does not include: 9
666624
667- (7) PSYCHIATRIC REHABILIT ATION SERVICES;
625+ 1. Clinic facility fees unless the health care service is 10
626+provided by a health care provider not authorized to bill a professional fee separately for 11
627+the health care service; or 12
668628
669- (8) PEER SUPPORT AND FAMI LY SUPPORTS;
629+ 2. Any room and board fees. 13
670630
671- (9) MEDICATION–ASSISTED TREATMENT ;
631+ (h) (1) The Department may specify in regulation the types of health care 14
632+providers eligible to receive reimbursement for health care services provided to Program 15
633+recipients under this section. 16
672634
673- (10) ASSERTIVE COMMUNITY T REATMENT; AND
635+ (2) If the Department specifies by regulation the types of health care 17
636+providers eligible to receive reimbursement for health care services provided to Program 18
637+recipients under this subsection, the regulations shall include all types of health care 19
638+providers that appropriately provide telehealth services. 20
674639
675- (11) COMMUNITY–BASED MENTAL HEALTH CARE FOR MILITARY
676-SERVICE MEMBERS AND VETERANS.
640+ (3) For the purpose of reimbursement and any fidelity standards 21
641+established by the Department, a health care service provided through telehealth is 22
642+equivalent to the same health care service when provided through an in –person 23
643+consultation. 24
677644
678- (B) ON OR BEFORE DECEMBER 1, 2023, THE DEPARTMENT SHALL SUBM IT
679-A STATE PLAN AMENDMENT TO THE CENTERS FOR MEDICARE AND MEDICAID
680-SERVICES TO ESTABLISH CERTIFIED COMMUNITY BEHAVIORAL HEALTH CL INICS IN
681-ACCORDANCE WITH § 223 OF THE FEDERAL PROTECTING ACCESS TO MEDICARE
682-ACT OF 2014.
645+ (i) Subject to subsection (g)(2) of this section, the Program or a managed care 25
646+organization that participates in the Program may not impose as a condition of 26
647+reimbursement of a covered health care service delivered through telehealth that the 27
648+health care service be provided by a third–party vendor designated by the Program. 28
683649
684- (C) IF THE AMENDMENT SUBMITTED U NDER SUBSECTION (B) OF THIS
685-SECTION IS APPROVED , THE DEPARTMENT SHALL AMEN D THE STATE PLAN IN
686-ACCORDANCE WITH TITLE XIX AND TITLE XXI OF THE SOCIAL SECURITY ACT AS
687-NECESSARY TO COVER :
650+ (j) The Department may adopt regulations to carry out this section. 29
688651
689- (1) ALL REQUIRED SERVICES FOR INDIVIDUALS WITH MENTAL
690-HEALTH NEEDS OR SUBS TANCE USE DISORDERS AT CERTIFIED COMMUNI TY
691-BEHAVIORAL HEALTH CL INICS THROUGH A DAIL Y BUNDLED PAYMENT Ch. 291 2023 LAWS OF MARYLAND
652+ (k) The Department shall obtain any federal authority necessary to implement 30
653+the requirements of this section, including applying to the Centers for Medicare and 31
654+Medicaid Services for an amendment to any of the State’s § 1115 waivers or the State plan. 32
655+ HOUSE BILL 1148 15
692656
693-– 16 –
694-METHODOLOGY THAT IS IN ALIGNMENT WITH FE DERAL PAYMENT FROM T HE
695-CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR THE CERT IFIED
696-COMMUNITY BEHAVIORAL HEALTH CLINICS MEDICAID DEMONSTRATIO N UNDER §
697-223 OF THE FEDERAL PROTECTING ACCESS TO MEDICARE ACT OF 2014; AND
698657
699- (2) ANY ADDITIONAL SERVIC ES IDENTIFIED BY THE DEPARTMENT .
658+ (l) This section may not be construed to supersede the authority of the Health 1
659+Services Cost Review Commission to set the appropriate rates for hospitals, including 2
660+setting the hospital facility fee for hospital–provided telehealth. 3
700661
701- (D) (1) THE DEPARTMENT SHALL ESTA BLISH STANDARDS AND
702-METHODOLOGIES FOR A PROSPECTIVE PAYMENT SYSTEM TO REIMBURSE A
703-CERTIFIED COMMUNITY BEHAVIORAL HEALTH CL INIC UNDER THE PROGRAM ON A
704-PREDETERMINED FIXED AMOUNT PER DAY FOR C OVERED SERVICES PROV IDED TO A
705-PROGRAM RECIPIENT .
662+15–141.5. 4
706663
707- (2) THE PROSPECTIVE PAYME NT RATE FOR A CERTIFIED COMMU NITY
708-BEHAVIORAL HEALTH CL INIC SHALL:
664+ (A) IN THIS SECTION , “CERTIFIED COMMUNITY BEHAVIORAL HEALTH 5
665+CLINIC” MEANS A NONPROFIT CO MPREHENSIVE COMMUNIT Y MENTAL HEALTH OR 6
666+SUBSTANCE USE TREATM ENT ORGANIZATION LICENSED BY THE STATE THAT MEETS 7
667+THE FEDERAL CERTIFIC ATION CRITERIA OF § 223 OF THE FEDERAL PROTECTING 8
668+ACCESS TO MEDICARE ACT OF 2014 AND OFFERS , DIRECTLY OR INDIRECT LY 9
669+THROUGH FORMAL REFER RAL RELATIONSHIPS WI TH OTHER PROVIDERS , THE 10
670+FOLLOWING SERVICES : 11
709671
710- (I) BE ADJUSTED ONCE EVER Y 3 YEARS BY THE MEDICARE
711-ECONOMIC INDEX IN ACCORDANCE W ITH § 223 OF THE FEDERAL PROTECTING
712-ACCESS TO MEDICARE ACT OF 2014; AND
672+ (1) OUTPATIENT MENTAL HEA LTH AND SUBSTANCE US E SERVICES; 12
713673
714- (II) ALLOW FOR MODIFICATIO NS BASED ON A CHANGE IN SCOPE
715-FOR AN INDIVIDUAL CE RTIFIED COMMUNITY BE HAVIORAL HEALTH CLIN IC.
674+ (2) 24–HOUR MOBILE CRISIS R ESPONSE AND HOTLINE SERVICES; 13
716675
717- (3) THE DEPARTMENT MAY CONSID ER RATE ADJUSTMENTS ON
718-REQUEST BY A CERTIFI ED COMMUNITY BEHAVIO RAL HEALTH CLINIC .
676+ (3) SCREENING, ASSESSMENT, AND DIAGNOSIS , INCLUDING RISK 14
677+ASSESSMENTS ; 15
719678
720- (E) (1) THE DEPARTMENT SHALL ESTA BLISH A QUALITY INCENTIVE
721-PAYMENT SYSTEM FOR A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CL INIC
722-THAT ACHIEVES SPECIF IED THRESHOLDS ON PE RFORMANCE METRICS
723-ESTABLISHED BY THE DEPARTMENT .
679+ (4) PERSON–CENTERED TREATMENT P LANNING; 16
724680
725- (2) THE QUALITY INCENTIVE PAYMENT SYSTEM ESTAB LISHED UNDER
726-PARAGRAPH (1) OF THIS SUBSECT ION SHALL BE IN ADDI TION TO THE PROSPECT IVE
727-PAYMENT RATE ESTABLI SHED UNDER SUBSECTIO N (D) OF THIS SECTION.
681+ (5) PRIMARY CARE SC REENING AND MONITORI NG OF KEY 17
682+INDICATORS OF HEALTH RISKS; 18
728683
729-Article – Insurance
684+ (6) TARGETED CASE MANAGEM ENT; 19
730685
731-15–139.
686+ (7) PSYCHIATRIC REHABILIT ATION SERVICES ; 20
732687
733- (a) (1) In this section, “telehealth” means, as it relates to the delivery of health
734-care services, the use of interactive audio, video, or other telecommunications or electronic
735-technology by a licensed health care provider to deliver a health care service within the
736-scope of practice of the health care provider at a location other than the location of the
737-patient. WES MOORE, Governor Ch. 291
688+ (8) PEER SUPPORT AND FAMI LY SUPPORTS; 21
738689
739-– 17 –
690+ (9) MEDICATION–ASSISTED TREATMENT ; 22
740691
741- (2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both
742-inclusive, an audio–only telephone conversation between a health care provider and a
743-patient that results in the delivery of a billable, covered health care service.
692+ (10) ASSERTIVE COMMUNITY T REATMENT; AND 23
744693
745- (3) “Telehealth” does not include:
694+ (11) COMMUNITY–BASED MENTAL HEALTH CARE FOR MILITARY 24
695+SERVICE MEMBERS AND VETERANS. 25
746696
747- (i) except as provided in paragraph (2) of this subsection, an
748-audio–only telephone conversation between a health care provider and a patient;
697+ (B) ON OR BEFORE DECEMBER 1, 2023, THE DEPARTMENT SHALL SUBM IT 26
698+A STATE PLAN AMENDMENT TO THE CENTERS FOR MEDICARE AND MEDICAID 27
699+SERVICES TO ESTABLISH CERTIFIED COMMUNIT Y BEHAVIORAL HEALTH CLINICS IN 28
700+ACCORDANCE WITH § 223 OF THE FEDERAL PROTECTING ACCESS TO MEDICARE 29
701+ACT OF 2014. 30
702+ 16 HOUSE BILL 1148
749703
750- (ii) an electronic mail message between a health care provider and a
751-patient; or
752704
753- (iii) a facsimile transmission between a health care provider and a
754-patient.
705+ (C) IF THE AMENDMENT SUBM ITTED UNDER SUBSECTI ON (B) OF THIS 1
706+SECTION IS APPROVED , THE DEPARTMENT SHALL AMEN D THE STATE PLAN IN 2
707+ACCORDANCE WITH TITLE XIX AND TITLE XXI OF THE SOCIAL SECURITY ACT AS 3
708+NECESSARY TO COVER : 4
755709
756- (b) This section applies to:
710+ (1) ALL REQUIRED SERVICES FOR INDIVIDUALS WITH MENTAL 5
711+HEALTH NEEDS OR SUBS TANCE USE DISORDERS AT CERTIFIED COMMUNI TY 6
712+BEHAVIORAL HEALTH CL INICS THROUGH A DAIL Y BUNDLED PAYMENT 7
713+METHODOLOGY THAT IS IN ALIGNMENT WITH FE DERAL PAYMENT FROM T HE 8
714+CENTERS FOR MEDICARE AND MEDICAID SERVICES FOR THE CERT IFIED 9
715+COMMUNITY BEHAVIORAL HEALTH CLINICS MEDICAID DEMONSTRATIO N UNDER § 10
716+223 OF THE FEDERAL PROTECTING ACCESS TO MEDICARE ACT OF 2014; AND 11
757717
758- (1) insurers and nonprofit health service plans that provide hospital,
759-medical, or surgical benefits to individuals or groups on an expense–incurred basis under
760-health insurance policies or contracts that are issued or delivered in the State; and
718+ (2) ANY ADDITIONAL SERVIC ES IDENTIFIED BY THE DEPARTMENT . 12
761719
762- (2) health maintenance organizations that provide hospital, medical, or
763-surgical benefits to individuals or groups under contracts that are issued or delivered in
764-the State.
720+ (D) (1) THE DEPARTMENT SHALL ESTA BLISH STANDARDS AND 13
721+METHODOLOGIES FOR A PROSPECTIVE PAYMENT SYSTEM TO REIMBURSE A 14
722+CERTIFIED COMMUNITY BEHAVIORAL HEALTH CL INIC UNDER THE PROGRAM ON A 15
723+PREDETER MINED FIXED AMOUNT P ER DAY FOR COVERED S ERVICES PROVIDED TO A 16
724+PROGRAM RECIPIENT . 17
765725
766- (c) (1) An entity subject to this section:
726+ (2) THE PROSPECTIVE PAYME NT RATE FOR A CERTIF IED COMMUNITY 18
727+BEHAVIORAL HEALTH CL INIC SHALL: 19
767728
768- (i) shall provide coverage under a health insurance policy or
769-contract for health care services appropriately delivered through telehealth regardless of
770-the location of the patient at the time the telehealth services are provided;
729+ (I) BE ADJUSTED ONCE EVER Y 3 YEARS BY THE MEDICARE 20
730+ECONOMIC INDEX IN ACCORDAN CE WITH § 223 OF THE FEDERAL PROTECTING 21
731+ACCESS TO MEDICARE ACT OF 2014; AND 22
771732
772- (ii) may not exclude from coverage a health care service solely
773-because it is provided through telehealth and is not provided through an in–person
774-consultation or contact between a health care provider and a patient; and
733+ (II) ALLOW FOR MODIFICATIO NS BASED ON A CHANGE IN SCOPE 23
734+FOR AN INDIVIDUAL CE RTIFIED COMMUNITY BE HAVIORAL HEALTH CLIN IC. 24
775735
776- (iii) may not exclude from coverage or deny coverage for a behavioral
777-health care service that is a covered benefit under a health insurance policy or contract
778-when provided in person solely because the behavioral health care service may also be
779-provided through a covered telehealth benefit.
736+ (3) THE DEPARTMENT MAY CONSID ER RATE ADJUSTMENTS ON 25
737+REQUEST BY A CERTIFI ED COMMUNITY BEHAVIO RAL HEALTH CLINIC . 26
780738
781- (2) The health care services appropriately delivered through telehealth
782-shall include counseling and treatment for substance use disorders and mental health
783-conditions.
784- Ch. 291 2023 LAWS OF MARYLAND
739+ (E) (1) THE DEPARTMENT SHALL ESTA BLISH A QUALITY INCE NTIVE 27
740+PAYMENT SYSTEM FOR A CERTIFIED COMMUNITY BEHAVIORAL HEALTH CL INIC 28
741+THAT ACHIEVES SPECIF IED THRESHOLDS ON PE RFORMANCE METRICS 29
742+ESTABLISHED BY THE DEPARTMENT . 30
785743
786-– 18 –
787- (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this
788-section:
744+ (2) THE QUALITY INCENTIVE PAYMENT SYSTEM ESTAB LISHED UNDER 31
745+PARAGRAPH (1) OF THIS SUBSECTION S HALL BE IN ADDITION TO THE PROSPECTIVE 32
746+PAYMENT RATE ESTABLI SHED UNDER SUBSECTIO N (D) OF THIS SECTION. 33
789747
790- (i) shall reimburse a health care provider for the diagnosis,
791-consultation, and treatment of an insured patient for a health care service covered under a
792-health insurance policy or contract that can be appropriately provided through telehealth;
748+Article – Insurance 34 HOUSE BILL 1148 17
793749
794- (ii) is not required to:
795750
796- 1. reimburse a health care provider for a health care service
797-delivered in person or through telehealth that is not a covered benefit under the health
798-insurance policy or contract; or
799751
800- 2. reimburse a health care provider who is not a covered
801-provider under the health insurance policy or contract; and
752+15–139. 1
802753
803- (iii) 1. may impose a deductible, copayment, or coinsurance
804-amount on benefits for health care services that are delivered either through an in–person
805-consultation or through telehealth;
754+ (a) (1) In this section, “telehealth” means, as it relates to the delivery of health 2
755+care services, the use of interactive audio, video, or other telecommunications or electronic 3
756+technology by a licensed health care provider to deliver a health care service within the 4
757+scope of practice of the health care provider at a location other than the location of the 5
758+patient. 6
806759
807- 2. may impose an annual dollar maximum as permitted by
808-federal law; and
760+ (2) “Telehealth” includes from July 1, 2021, to June 30, [2023] 2025, both 7
761+inclusive, an audio–only telephone conversation between a health care provider and a 8
762+patient that results in the delivery of a billable, covered health care service. 9
809763
810- 3. may not impose a lifetime dollar maximum.
764+ (3) “Telehealth” does not include: 10
811765
812- (2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when
813-a health care service is appropriately provided through telehealth, an entity subject to this
814-section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection
815-on the same basis and at the same rate as if the health care service were delivered by the
816-health care provider in person.
766+ (i) except as provided in paragraph (2) of this subsection, an 11
767+audio–only telephone conversation between a health care provider and a patient; 12
817768
818- (ii) The reimbursement required under subparagraph (i) of this
819-paragraph does not include:
769+ (ii) an electronic mail message between a health care provider and a 13
770+patient; or 14
820771
821- 1. clinic facility fees unless the health care service is
822-provided by a health care provider not authorized to bill a professional fee separately for
823-the health care service; or
772+ (iii) a facsimile transmission between a health care provider and a 15
773+patient. 16
824774
825- 2. any room and board fees.
775+ (b) This section applies to: 17
826776
827- (iii) This paragraph may not be construed to supersede the authority
828-of the Health Services Cost Review Commission to set the appropriate rates for hospitals,
829-including setting the hospital facility fee for hospital–provided telehealth.
777+ (1) insurers and nonprofit health service plans that provide hospital, 18
778+medical, or surgical benefits to individuals or groups on an expense–incurred basis under 19
779+health insurance policies or contracts that are issued or delivered in the State; and 20
830780
831- (e) Subject to subsection (d)(1)(ii) of this section, an entity subject to this section
832-may not impose as a condition of reimbursement of a covered health care service delivered WES MOORE, Governor Ch. 291
781+ (2) health maintenance organizations that provide hospital, medical, or 21
782+surgical benefits to individuals or groups under contracts that are issued or delivered in 22
783+the State. 23
833784
834-– 19 –
835-through telehealth that the health care service be provided by a third–party vendor
836-designated by the entity.
785+ (c) (1) An entity subject to this section: 24
837786
838- (f) An entity subject to this section may undertake utilization review, including
839-preauthorization, to determine the appropriateness of any health care service whether the
840-service is delivered through an in–person consultation or through telehealth if the
841-appropriateness of the health care service is determined in the same manner.
787+ (i) shall provide coverage under a health insurance policy or 25
788+contract for health care services appropriately delivered through telehealth regardless of 26
789+the location of the patient at the time the telehealth services are provided; 27
842790
843- (g) A health insurance policy or contract may not distinguish between patients in
844-rural or urban locations in providing coverage under the policy or contract for health care
845-services delivered through telehealth.
791+ (ii) may not exclude from coverage a health care service solely 28
792+because it is provided through telehealth and is not provided through an in–person 29
793+consultation or contact between a health care provider and a patient; and 30
846794
847- (h) A decision by an entity subject to this section not to provide coverage for
848-telehealth in accordance with this section constitutes an adverse decision, as defined in §
849-15–10A–01 of this title, if the decision is based on a finding that telehealth is not medically
850-necessary, appropriate, or efficient.
795+ (iii) may not exclude from coverage or deny coverage for a behavioral 31
796+health care service that is a covered benefit under a health insurance policy or contract 32 18 HOUSE BILL 1148
851797
852- SECTION 4. AND BE IT FURTHER ENACTED, That:
853798
854- (a) The Maryland Health Care Commission shall study and make
855-recommendations regarding the delivery of health care services through telehealth,
856-including payment parity for the delivery of health care services through audiovisual and
857-audio–only telehealth technologies.
799+when provided in person solely because the behavioral health care service may also be 1
800+provided through a covered telehealth benefit. 2
858801
859- (b) In conducting the study required under subsection (a) of this section, the
860-Maryland Health Care Commission shall:
802+ (2) The health care services appropriately delivered through telehealth 3
803+shall include counseling and treatment for substance use disorders and mental health 4
804+conditions. 5
861805
862- (1) determine whether it is more or less costly for health care providers to
863-deliver health care services through telehealth;
806+ (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 6
807+section: 7
864808
865- (2) determine whether the delivery of health care services through
866-telehealth requires more or less clinical effort on the part of the health care provider;
809+ (i) shall reimburse a health care provider for the diagnosis, 8
810+consultation, and treatment of an insured patient for a health care service covered under a 9
811+health insurance policy or contract that can be appropriately provided through telehealth; 10
867812
868- (3) to help inform the debate on payment parity, identify the aspects of
869-telehealth that are subject to overuse or underuse or yield greater or lower value;
813+ (ii) is not required to: 11
870814
871- (4) assess the adequacy of reimbursement for behavioral health services
872-delivered in person and by telehealth; and
815+ 1. reimburse a health care provider for a health care service 12
816+delivered in person or through telehealth that is not a covered benefit under the health 13
817+insurance policy or contract; or 14
873818
874- (5) address any other issues related to telehealth as determined necessary
875-by the Commission.
819+ 2. reimburse a health care provider who is not a covered 15
820+provider under the health insurance policy or contract; and 16
876821
877- (c) On or before December 1, 2024, the Maryland Health Care Commission shall
878-submit a report on its findings and recommendations to the General Assembly, in
879-accordance with § 2–1257 of the State Government Article.
880- Ch. 291 2023 LAWS OF MARYLAND
822+ (iii) 1. may impose a deductible, copayment, or coinsurance 17
823+amount on benefits for health care services that are delivered either through an in–person 18
824+consultation or through telehealth; 19
881825
882-– 20 –
883- SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of
884-Health shall apply to the Substance Abuse and Mental Health Services Administration at
885-the Center for Mental Health Services for federal planning, developm ent, and
886-implementation grant funds related to certified community behavioral health clinics for
887-fiscal year 2025.
826+ 2. may impose an annual dollar maximum as permitted by 20
827+federal law; and 21
888828
889- SECTION 6. AND BE IT FURTHER ENACTED, That the Maryland Department of
890-Health shall apply to the Substance Abuse and Mental Health Services Administration at
891-the Center for Mental Health Services for inclusion in the state certified community
892-behavioral health clinic demonstration program for fiscal year 2026.
829+ 3. may not impose a lifetime dollar maximum. 22
893830
894- SECTION 4. 7. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall
895-take effect October 1, 2023. It shall remain effective for a period of 4 years and 2 months
896-and, at the end of November 30, 2027, Section 2 of this Act, with no further action required
897-by the General Assembly, shall be abrogated and of no further force and effect.
831+ (2) (i) From July 1, 2021, to June 30, [2023] 2025, both inclusive, when 23
832+a health care service is appropriately provided through telehealth, an entity subject to this 24
833+section shall provide reimbursement in accordance with paragraph (1)(i) of this subsection 25
834+on the same basis and at the same rate as if the health care service were delivered by the 26
835+health care provider in person. 27
898836
899- SECTION 5. 8. AND BE IT FURTHER ENACTED, That, except as provided in
900-Section 4 7 of this Act, this Act shall take effect June 1, 2023. Section 1 of this Act shall
901-remain effective for a period of 4 years and 1 month and, at the end of June 30, 2027, Section
902-1 of this Act, with no further action required by the General Assembly, shall be abrogated
903-and of no further force and effect.
837+ (ii) The reimbursement required under subparagraph (i) of this 28
838+paragraph does not include: 29
904839
905-Approved by the Governor, May 3, 2023.
840+ 1. clinic facility fees unless the health care service is 30
841+provided by a health care provider not authorized to bill a professional fee separately for 31
842+the health care service; or 32
843+
844+ 2. any room and board fees. 33
845+ HOUSE BILL 1148 19
846+
847+
848+ (iii) This paragraph may not be construed to supersede the authority 1
849+of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 2
850+including setting the hospital facility fee for hospital–provided telehealth. 3
851+
852+ (e) Subject to subsection (d)(1)(ii) of this section, an entity subject to this section 4
853+may not impose as a condition of reimbursement of a covered health care service delivered 5
854+through telehealth that the health care service be provided by a third–party vendor 6
855+designated by the entity. 7
856+
857+ (f) An entity subject to this section may undertake utilization review, including 8
858+preauthorization, to determine the appropriateness of any health care service whether the 9
859+service is delivered through an in–person consultation or through telehealth if the 10
860+appropriateness of the health care service is determined in the same manner. 11
861+
862+ (g) A health insurance policy or contract may not distinguish between patients in 12
863+rural or urban locations in providing coverage under the policy or contract for health care 13
864+services delivered through telehealth. 14
865+
866+ (h) A decision by an entity subject to this section not to provide coverage for 15
867+telehealth in accordance with this section constitutes an adverse decision, as defined in § 16
868+15–10A–01 of this title, if the decision is based on a finding that telehealth is not medically 17
869+necessary, appropriate, or efficient. 18
870+
871+ SECTION 4. AND BE IT FURTHER ENACTED, That: 19
872+
873+ (a) The Maryland Health Care Commission shall study and make 20
874+recommendations regarding the delivery of health care services through telehealth, 21
875+including payment parity for the delivery of health care services through audiovisual and 22
876+audio–only telehealth technologies. 23
877+
878+ (b) In conducting the study required under subsection (a) of this section, the 24
879+Maryland Health Care Commission shall: 25
880+
881+ (1) determine whether it is more or less costly for health care providers to 26
882+deliver health care services through telehealth; 27
883+
884+ (2) determine whether the delivery of health care services through 28
885+telehealth requires more or less clinical effort on the part of the health care provider; 29
886+
887+ (3) to help inform the debate on payment parity, identify the aspects of 30
888+telehealth that are subject to overuse or underuse or yield greater or lower value; 31
889+
890+ (4) assess the adequacy of reimbursement for behavioral health services 32
891+delivered in person and by telehealth; and 33
892+
893+ (5) address any other issues related to telehealth as determined necessary 34
894+by the Commission. 35 20 HOUSE BILL 1148
895+
896+
897+
898+ (c) On or before December 1, 2024, the Maryland Health Care Commission shall 1
899+submit a report on its findings and recommendations to the General Assembly, in 2
900+accordance with § 2–1257 of the State Government Article. 3
901+
902+ SECTION 5. AND BE IT FURTHER ENACTED, That the Maryland Department of 4
903+Health shall apply to the Substance Abuse and Mental Health Services Administration at 5
904+the Center for Mental Health Services for federal planning, development, and 6
905+implementation grant funds related to certified community behavioral health clinics for 7
906+fiscal year 2025. 8
907+
908+ SECTION 6. AND BE IT FURTHER ENACTED, That the Maryland Department of 9
909+Health shall apply to the Substance Abuse and Mental Health Services Administration at 10
910+the Center for Mental Health Services for inclusion in the state certified community 11
911+behavioral health clinic demonstration program for fiscal year 2026. 12
912+
913+ SECTION 4. 7. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall 13
914+take effect October 1, 2023. It shall remain effective for a period of 4 years and 2 months 14
915+and, at the end of November 30, 2027, Section 2 of this Act, with no further action required 15
916+by the General Assembly, shall be abrogated and of no further force and effect. 16
917+
918+ SECTION 5. 8. AND BE IT FURTHER ENACTED, That, except as provided in 17
919+Section 4 7 of this Act, this Act shall take effect June 1, 2023. Section 1 of this Act shall 18
920+remain effective for a period of 4 years and 1 month and, at the end of June 30, 2027, Section 19
921+1 of this Act, with no further action required by the General Assembly, shall be abrogated 20
922+and of no further force and effect. 21
923+
924+
925+
926+
927+Approved:
928+________________________________________________________________________________
929+ Governor.
930+________________________________________________________________________________
931+ Speaker of the House of Delegates.
932+________________________________________________________________________________
933+ President of the Senate.