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Chapter 248
(Senate Bill 786)
AN ACT concerning
Health – Reproductive Health Services – Protected Information and Insurance
Requirements
FOR the purpose of regulating the disclosure of certain information related to
legally protected health care by custodians of public records, health care providers,
health information exchanges, and dispensers electronic health networks; repealing
a provision of law authorizing a custodian to allow inspection of the part of a public
record that gives the home address of a licensee under certain circumstances;
requiring that the regulations adopted by the Maryland Health Care Commission
regarding clinical information to be exchanged through the State–designated
exchange restrict data of patients who have obtained legally protected health care;
establishing the Protected Health Care Commission; altering the purpose of the
Maryland Health Care Commission to include the establishment of policies and
standards that protect the confidentiality of certain health care information;
clarifying that certain insurance requirements regarding abortion care services
apply notwithstanding a certain restriction; and generally relating to health
information and reproductive health services.
BY repealing and reenacting, with amendments,
Article – General Provisions
Section 4–333
Annotated Code of Maryland
(2019 Replacement Volume and 2022 Supplement)
BY repealing and reenacting, with amendments,
Article – Health – General
Section 4–301, 4–302.3, 4–305, 4–309, 19–103, and 19–145 and 19–103
Annotated Code of Maryland
(2019 Replacement Volume and 2022 Supplement)
BY adding to
Article – Health – General
Section 4–302.5 and 4–310
Annotated Code of Maryland
(2019 Replacement Volume and 2022 Supplement)
BY repealing and reenacting, with amendments,
Article – Insurance
Section 15–857
Annotated Code of Maryland
(2017 Replacement Volume and 2022 Supplement) Ch. 248 2023 LAWS OF MARYLAND
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BY repealing and reenacting, without amendments,
Article – Insurance
Section 31–116(a)
Annotated Code of Maryland
(2017 Replacement Volume and 2022 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – General Provisions
4–333.
(a) Subject to subsections (b) through (d) of this section, a custodian shall deny
inspection of the part of a public record that:
(1) contains information about the licensing of an individual in an
occupation or a profession;
(2) CONTAINS THE NAME OF AN INDIVIDUAL OR OTHER IDENTIFYING
INFORMATION OF AN INDIVIDUAL RELATED TO AN AMBULATORY SURGER Y CENTER:
(I) EXCEPT AS PROVIDED I N SUBSECTION (B)(8) OF THIS
SECTION, AN AMBULATORY SURGIC AL FACILITY LICENSED UNDER § 19–3B–01 OF
THE HEALTH – GENERAL ARTICLE OR A; OR
(II) A SURGICAL ABORTION FA CILITY LICENSED UNDE R §
20–209 OF THE HEALTH – GENERAL ARTICLE; OR
(3) RELATES TO AN INVEST IGATION OF A LICENSE E OR CERTIFICATE
HOLDER REGARDING THE PROVISION OF LEGALLY P ROTECTED HEALTH CARE , AS
DEFINED IN § 4–301 OF THE HEALTH – GENERAL ARTICLE, PENDING A FINAL
ORDER.
(b) A custodian shall allow inspection of the part of a public record that gives:
(1) the name of the licensee;
(2) (I) SUBJECT TO ITEM (II) OF THIS ITEM, the business address of
the licensee [or, if the business address is not available, the home address of the licensee
after the custodian redacts any information that identifies the location as the home address
of an individual with a disability as defined in § 20–701 of the State Government Article];
OR
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(II) IF THE LICENSEE IS L ICENSED BY A HEALTH OCCUPATIONS
BOARD, THE BUSINESS ADDRESS OF THE LICENSEE ;
(3) the business telephone number of the licensee;
(4) the educational and occupational background of the licensee;
(5) the professional qualifications of the licensee;
(6) any orders and findings that result from formal disciplinary actions;
and
(7) any evidence that has been provided to the custodian to meet the
requirements of a statute as to financial responsibility; AND
(8) FOR AN AMBULATORY SU RGICAL FACILITY LICE NSED UNDER §
19–3B–01 OF THE HEALTH – GENERAL ARTICLE, THE OWNER, PRIMARY CONTACT ,
ATTORNEY, OR CONSULTANT CONTAI NED IN AN APPLICATIO N TO THE MARYLAND
HEALTH CARE COMMISSION FOR A CERT IFICATE OF NEED OR C ERTIFICATE OF
NEED EXCEPTION OR DE TERMINATION REQUEST .
(c) A custodian may allow inspection of other information about a licensee if:
(1) the custodian finds a compelling public purpose; and
(2) the rules or regulations of the official custodian allow the inspection.
(d) Except as otherwise provided by this section or other law, a custodian shall
allow inspection by the person in interest.
(e) A custodian who sells lists of licensees shall omit from the lists the name of
any licensee, on written request of the licensee.
Article – Health – General
4–301.
(a) In this subtitle the following words have the meanings indicated.
(b) “Common ownership” means ownership of a health care entity:
(1) By two or more health care providers;
(2) By two or more health care providers employed by a mutual employer
for a wage, salary, fee, or payment to perform work for the employer;
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(3) By health care organizations operating as an organized health care
arrangement, as defined in 45 C.F.R. § 160.103;
(4) By a health care entity or health care entities that possess an ownership
or equity interest of 5% or more in another health care entity; or
(5) By affiliated providers operating under the same trade name.
(c) “Directory information” means information concerning the presence and
general health condition of a patient who has been admitted to a health care facility or who
is currently receiving emergency health care in a health care facility.
(d) “Disclose” or “disclosure” means the transmission or communication of
information in a medical record, including an acknowledgment that a medical record on a
particular patient or recipient exists.
(e) “Emergency” means a situation when, in the professional opinion of the health
care provider, a clear and significant risk of death or imminent serious injury or harm to a
patient or recipient exists.
(f) “General health condition” means the health status of a patient described in
terms of “critical”, “poor”, “fair”, “good”, “excellent”, or terms denoting similar conditions.
(g) “Health care” means any care, treatment, or procedure by a health care
provider:
(1) To diagnose, evaluate, rehabilitate, manage, treat, or maintain the
physical or mental condition of a patient or recipient; or
(2) That affects the structure or any function of the human body.
(h) (1) “Health care provider” means:
(i) A person who is licensed, certified, or otherwise authorized under
the Health Occupations Article or § 13–516 of the Education Article to provide health care
in the ordinary course of business or practice of a profession or in an approved education or
training program; or
(ii) A facility where health care is provided to patients or recipients,
including a facility as defined in § 10–101(g) of this article, a hospital as defined in §
19–301 of this article, a related institution as defined in § 19–301 of this article, a health
maintenance organization as defined in § 19–701(g) of this article, an outpatient clinic, a
medical laboratory, a comprehensive crisis response center, a crisis stabilization center,
and a crisis treatment center established under § 7.5–207 of this article.
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(2) “Health care provider” includes the agents, employees, officers, and
directors of a facility and the agents and employees of a health care provider.
(i) (1) “Health information exchange” means:
(i) An individual or entity that determines, controls, or has the
discretion to administer any requirement, policy, or agreement that allows, enables, or
requires the use of any technology or services for access, exchange, or use of electronic
protected health care information:
1. Among more than two unaffiliated individuals or entities
that are enabled to exchange electronic protected health information with each other; and
2. That is for a treatment, payment, or health care
operations purpose, as those terms are defined in 45 C.F.R. § 164.501, regardless of whether
the individuals or entities are subject to the requirements of 45 C.F.R. parts 160 and 164;
or
(ii) A health information technology developer of certified health
information technology that develops or offers health information technology, as that term
is defined in 42 U.S.C. 300jj(5), and has one or more Health Information Technology
Modules certified under a program for the voluntary certification of health information
technology that is kept or recognized by the National Coordinator in accordance with 42
U.S.C. 300jj–11(c)(5).
(2) “Health information exchange” does not include:
(i) An entity composed of health care providers under common
ownership if the organizational and technical processes the entity provides or governs are
for health care treatment, payment, or health care operations purposes, as those terms are
defined in 45 C.F.R. § 164.501;
(ii) A carrier, as defined in § 15–1301 of the Insurance Article if the
organizational and technical processes the carrier provides or governs are for health care
treatment, payment, or health care operations purposes, as those terms are defined in 45
C.F.R. § 164.501;
(iii) An administrator, as defined in § 8–301 of the Insurance Article,
if the organizational and technical processes the administrator provides or governs are for
health care treatment, payment, or health care operations purposes, as those terms are
defined in 45 C.F.R. § 164.501;
(iv) A health care provider, as defined in subsection (h) of this section,
if the organizational and technical processes the health care provider provides or governs
are for health care treatment, payment, or health care operations purposes, as those terms
are defined in 45 C.F.R. § 164.501; Ch. 248 2023 LAWS OF MARYLAND
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(v) A carrier’s business associate, as defined in 45 C.F.R. § 160.103,
if the organizational and technical processes provided or governed by the business associate
are transactions, as defined in 45 C.F.R. § 160.103; or
(vi) A carrier exchanging information as required by 45 C.F.R. §
156.221.
(j) “LEGALLY PROTECTED HEA LTH CARE” MEANS ALL REPRODUCTI VE
HEALTH SERVICES , MEDICATIONS , AND SUPPLIES RELATED TO THE DIRECT
PROVISION OR SUPPORT OF THE PROVISION OF CARE RELATED TO PREG NANCY,
CONTRACEPTION , ASSISTED REPRODUCTIO N, AND ABORTION THAT IS LAWFUL IN
THE STATE:
(1) THE PROVISION OF ABORTIO N CARE; AND
(2) OTHER SENSITIVE HEALT H SERVICES AS DETERM INED BY THE
SECRETARY BASED ON TH E RECOMMENDATIONS OF THE PROTECTED HEALTH
CARE COMMISSION ESTABLISHE D UNDER § 4–310 OF THIS SUBTITLE.
(K) (1) “Medical record” means any oral, written, or other transmission in any
form or medium of information that:
(i) Is entered in the record of a patient or recipient;
(ii) Identifies or can readily be associated with the identity of a
patient or recipient; and
(iii) Relates to the health care of the patient or recipient.
(2) “Medical record” includes any:
(i) Documentation of disclosures of a medical record to any person
who is not an employee, agent, or consultant of the health care provider;
(ii) File or record maintained under § 12–403(c)(13) of the Health
Occupations Article by a pharmacy of a prescription order for drugs, medicines, or devices
that identifies or may be readily associated with the identity of a patient;
(iii) Documentation of an examination of a patient regardless of who:
1. Requested the examination; or
2. Is making payment for the examination; and
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(iv) File or record received from another health care provider that:
1. Relates to the health care of a patient or recipient received
from that health care provider; and
2. Identifies or can readily be associated with the identity of
the patient or recipient.
[(k)] (L) (1) “Mental health services” means health care rendered to a
recipient primarily in connection with the diagnosis, evaluation, treatment, case
management, or rehabilitation of any mental disorder.
(2) For acute general hospital services, mental health services are
considered to be the primarily rendered service only if service is provided pursuant to Title
10, Subtitle 6 of this article or Title 3 of the Criminal Procedure Article.
[(l)] (M) “Patient” means a person who receives health care and on whom a
medical record is maintained.
[(m)] (N) “Person in interest” means:
(1) An adult on whom a health care provider maintains a medical record;
(2) A person authorized to consent to health care for an adult consistent
with the authority granted;
(3) A duly appointed personal representative of a deceased person;
(4) (i) A minor, if the medical record concerns treatment to which the
minor has the right to consent and has consented under Title 20, Subtitle 1 of this article;
or
(ii) A parent, guardian, custodian, or a representative of the minor
designated by a court, in the discretion of the attending physician who provided the
treatment to the minor, as provided in § 20–102 or § 20–104 of this article;
(5) If item (4) of this subsection does not apply to a minor:
(i) A parent of the minor, except if the parent’s authority to consent
to health care for the minor has been specifically limited by a court order or a valid
separation agreement entered into by the parents of the minor; or
(ii) A person authorized to consent to health care for the minor
consistent with the authority granted; or
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(6) An attorney appointed in writing by a person listed in item (1), (2), (3),
(4), or (5) of this subsection.
[(n)] (O) “Primary provider of mental health services” means the designated
mental health services provider who:
(1) Has primary responsibility for the development of the mental health
treatment plan for the recipient; and
(2) Is actively involved in providing that treatment.
[(o)] (P) “Protected health information” means all individually identifiable
health information held or transmitted by a covered entity or its business associate
protected under the U.S. Department of Health and Human Services Privacy Rule.
(Q) “PROTECTED MEDICATION RECORD” MEANS ANY IDENTIFYIN G
INFORMATION ABOUT TH E PATIENT OR PRESCRI BER OF MEDICATION US ED IN A
MEDICAL ABORTION IF THE MEDICATION :
(1) HAS BEEN APPROVED BY THE FEDERAL FOOD AND DRUG
ADMINISTRATION FOR ME DICAL ABORTION ; OR
(2) IS RECOGNIZED BY THE SECRETARY.
(R) (1) “PROTECTED SERVICES RE CORD” MEANS ANY IDENTIFYIN G
INFORMATION CONTAINED IN A PATIE NT’S MEDICAL RECORD REL ATING TO THE
PROVISION OF LEGALLY PROTECTED HEALTH CAR E.
(2) “PROTECTED SERVICES RE CORD” DOES NOT INCLUDE A
PROTECTED MEDICATION RECORD.
[(p)] (S) (Q) “Recipient” means a person who has applied for, for whom an
application has been submitted, or who has received mental health services.
(R) “SENSITIVE HEALTH SERV ICES” INCLUDES REPRODUCTIV E HEALTH
SERVICES OTHER THAN ABORTION CARE .
[(q)] (T) (S) “State–designated health information exchange” means the health
information exchange designated by the Maryland Health Care Commission and the
Health Services Cost Review Commission under § 19–143 of this article.
4–302.3.
(a) (1) In this section the following words have the meanings indicated.
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(2) “Electronic health care transactions” means health care transactions
that have been approved by a nationally recognized health care standards development
organization to support health care informatics, information exchange, systems
integration, and other health care applications.
(3) “Electronic health network” means an entity:
(i) Involved in the exchange of electronic health care transactions
between a payor, health care provider, vendor, and any other entity; and
(ii) Certified by the Maryland Health Care Commission.
(4) “Nursing home” has the meaning stated in § 19–1401 of this article.
(5) “Standard request” means a request for clinical information from a
health information exchange that conforms to the major standards version specified by the
Office of the National Coordinator for Health Information Technology.
(b) This section applies to:
(1) Except for the State–designated health information exchange, a health
information exchange operating in the State; and
(2) A payor that:
(i) Holds a valid certificate of authority issued by the Maryland
Insurance Commissioner; and
(ii) Acts as, operates, or owns a health information exchange.
(c) An entity to which this section applies shall connect to the State–designated
health information exchange in a manner consistent with applicable federal and State
privacy laws.
(d) When a standard request for clinical information is received through the
State–designated health information exchange, an entity to which this section applies
shall:
(1) Respond to the request to the extent authorized under federal and State
privacy laws; and
(2) Transmit the response to the State–designated health information
exchange in the manner specified in the regulations adopted under subsection (g) of this
section.
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(e) A consent from a patient to release clinical information to a provider obtained
by an entity to which this section applies shall apply to information transmitted through
the State–designated health information exchange or by other means.
(f) (1) On request of the Department, a nursing home shall submit
electronically clinical information to the State–designated health information exchange to
facilitate the objectives stated in paragraph (3) of this subsection.
(2) In accordance with State and federal law and to facilitate the objectives
stated in paragraph (3) of this subsection, the State–designated health information
exchange may provide the information submitted under paragraph (1) of this subsection to:
(i) A health care provider;
(ii) An authorized health information exchange user;
(iii) A health information exchange authorized by the Maryland
Health Care Commission;
(iv) A federal official; and
(v) A State official.
(3) (i) If approved by the Maryland Health Care Commission, the
information submitted under paragraph (1) of this subsection may be combined with other
data maintained by the State–designated health information exchange to facilitate:
1. A State health improvement program;
2. Mitigation of a public health emergency; and
3. Improvement of patient safety.
(ii) The information submitted by a nursing home under paragraph
(1) of this subsection may be used only to facilitate the objectives stated in subparagraph
(i) of this paragraph and may not be used for any other purpose, including licensing and
certification.
(g) (1) The State–designated health information exchange shall:
(i) Participate in the advisory committee established under §
13–4306(a)(1) of this article; and
(ii) Maintain a data set for the Maryland Commission on Health
Equity and provide data from the data set consistent with the parameters defined by the
advisory committee. WES MOORE, Governor Ch. 248
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(2) If approved by the Maryland Commission on Health Equity, the
State–designated health information exchange may use the data set maintained under
paragraph (1) of this subsection to improve health outcomes for patients.
(h) (1) An electronic health network shall provide electronic health care
transactions to the State–designated health information exchange for the following public
health and clinical purposes:
(i) A State health improvement program;
(ii) Mitigation of a public health emergency; and
(iii) Improvement of patient safety.
(2) An electronic health network may not charge a fee to a health care
provider, health care payor, or to the State–designated health information exchange for
providing the information as required under paragraph (1) of this subsection.
(3) The State–designated health information exchange shall develop and
implement policies and procedures to implement paragraph (1) of this subsection that are
consistent with regulations adopted by the Maryland Health Care Commission.
(i) The Maryland Health Care Commission:
(1) Shall adopt regulations for implementing the connectivity to the
State–designated health information exchange required under this section; and
(2) Shall seek, through any regulations adopted under item (1) of this
subsection, to promote technology standards and formats that conform to those specified by
the Office of the National Coordinator for Health Information Technology.
(j) (1) The Maryland Health Care Commission shall adopt regulations that:
(i) Specify the scope of clinical information to be exchanged or sent
under this section; and
(ii) Provide for a uniform, gradual implementation of the exchange
of clinical information under this section.
(2) Any regulations adopted under paragraph (1) of this subsection shall
limit the scope of the clinical information to purposes that:
(i) Improve treatment, including improved access to clinical records
by treating clinicians;
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(ii) Promote uses of the State–designated health information
exchange important to public health; or
(iii) The protection of the electronic health information of a person in
interest who has opted out of having electronic health information shared or disclosed by a
health information exchange.
(3) Regulations adopted under paragraph (1) of this subsection shall:
(i) Limit redisclosure of financial information, including billed or
paid amounts available in electronic claims transactions;
(ii) Restrict data of patients who have opted out of records sharing
through the State–designated health information exchange or a health information
exchange authorized by the Maryland Health Care Commission; [and]
(iii) Restrict data from health care providers that possess sensitive
health care information; AND
(IV) RESTRICT DATA OF PATI ENTS WHO HAVE OBTAIN ED
LEGALLY PROTECTED HEALTH CARE.
(k) This section does not:
(1) Require an entity to which this section applies to collect clinical
information or obtain any authorizations, not otherwise required by federal or State law,
relating to information to be sent or received through the State–designated health
information exchange;
(2) Prohibit an entity to which this section applies from directly receiving
or sending information to providers or subscribers outside of the State–designated health
information exchange; or
(3) Prohibit an entity to which this section applies from connecting and
interoperating with the State–designated health information exchange in a manner and
scope beyond that required under this section.
4–302.5.
(A) SUBJECT TO SUBSECTION (D)(3)(II) OF THIS SECTION , THIS SECTION
APPLIES TO DISCLOSUR ES OF HEALTH INFORMA TION TO RECIPIENTS L OCATED IN
THE STATE AND OUTSIDE THE STATE.
(A) (B) A SUBJECT TO SUBSECTION (D)(3)(II) OF THIS SECTION ,
BEGINNING DECEMBER 1, 2023, A HEALTH INFORMATION E XCHANGE OR WES MOORE, Governor Ch. 248
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ELECTRONIC HEALTH NE TWORK MAY NOT DISCLOSE A PROTECTED SERVICES
RECORD OR PROTECTED MEDICATION RECORD TO A TREATING PROVIDER,
BUSINESS ENTITY , OR HEALTH INFORMATIO N EXCHANGE LOCATED OUTSIDE THE
STATE MIFEPRISTONE DATA OR THE DIAGNOSIS, PROCEDURE , MEDICATION, OR
RELATED CODES FOR AB ORTION CARE AND OTHE R SENSITIVE HEALTH S ERVICES AS
DETERMINED BY THE SECRETARY UNDER SUBSE CTION (D) OF THIS SECTION TO A
TREATING PROVIDER , A BUSINESS ENTITY , ANOTHER HEALTH INFOR MATION
EXCHANGE, OR ANOTHER ELECTRONIC H EALTH NETWORK UNLESS THE
DISCLOSURE IS:
(1) FOR THE ADJUDICATION OF CLAIMS; OR
(2) TO A SPECIFIC TREATIN G PROVIDER AT THE WR ITTEN REQUEST
OF AND WITH THE CONS ENT OF:
(I) A PATIENT, FOR SERVICES FOR WHI CH THE PATIENT CAN
PROVIDE CONSENT UNDE R STATE LAW; OR
(II) A PARENT OR GUARDIAN O F A PATIENT, FOR SERVICES FOR
WHICH THE PARENT OR GUARDIAN CAN PROVIDE CONSENT UNDER STATE LAW.
(B) (1) (C) (1) A BEGINNING JUNE 1, 2024, A PERSON WHO
KNOWINGLY VIOLATES T HIS SECTION IS GUILTY OF A MISDEMEA NOR AND ON
CONVICTION IS SUBJEC T TO A FINE NOT TO E XCEED $10,000 PER DAY.
(2) IN DETERMINING THE FI NE TO BE IMPOSED UND ER PARAGRAPH
(1) OF THIS SUBSECTION , THE FOLLOWING FACTOR S SHALL BE CONSIDERE D:
(I) THE EXTENT OF ACTUAL OR POTENTIAL PUBLIC HARM
CAUSED BY THE VIOLAT ION;
(II) THE COST OF INVESTIGA TING THE VIOLATION ; AND
(III) WHETHER THE PERSON PR EVIOUSLY VIOLATED TH IS
SECTION.
(C) (D) (1) THE SECRETARY SHALL :
(1) ADOPT REGULATIONS THA T IDENTIFY THE MEDIC ATIONS TO BE
CONSIDERED A MEDICAT ION USED IN A MEDICA L ABORTION FOR PURPO SES OF
DETERMINING IF A REC ORD IS A PROTECTED M EDICATION RECORD ; AND
(2) FOLLOW GUIDELINES OF THE AMERICAN COLLEGE OF
OBSTETRICIANS AND GYNECOLOGISTS , THE WORLD HEALTH ORGANIZATION, AND Ch. 248 2023 LAWS OF MARYLAND
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THE SOCIETY OF FAMILY PLANNING IN DETERMINI NG WHICH MEDICATIONS TO
IDENTIFY IN THE REGU LATIONS ADOPTED UNDE R ITEM (1) OF THIS SUBSECTION
DETERMINE FOR ABORTI ON CARE AND SENSITIV E HEALTH SERVICES TH E
PROCEDURE , DIAGNOSIS, MEDICATION, AND OTHER RELATED CO DES THAT ARE
SUBJECT TO THE RESTR ICTIONS ON DISCLOSUR E ESTABLISHED UNDER
SUBSECTION (B) OF THIS SECTION DUE TO A SUBSTANTIAL RIS K TO PATIENTS OR
HEALTH CARE PROVIDER S THAT WOULD RESULT FROM DISCLOSURE .
(2) A DETERMINATION MADE U NDER PARAGRAPH (1) OF THIS
SUBSECTION SHALL:
(I) FOLLOW APPLICABLE GUI DELINES OF THE AMERICAN
COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS , THE WORLD HEALTH
ORGANIZATION, AND THE SOCIETY OF FAMILY PLANNING; AND
(II) FOR SENSITIVE HEALTH SERVICES, BE BASED ON THE
RECOMMENDATIONS OF THE PROTECTED HEALTH CARE COMMISSION
ESTABLISHED UNDER § 4–310 OF THIS SUBTITLE.
(3) (I) THE SECRETARY SHALL ADOPT REGULATIONS TO RESTR ICT
THE DISCLOSURE OF AB ORTION CARE AND OTHE R SENSITIVE HEALTH S ERVICES
INFORMATION BY DIAGN OSIS, PROCEDURE , MEDICATION, OR RELATED CODES
UNDER SUBSECTION (B) OF THIS SECTION.
(II) EXCEPT AS PROVIDED IN SUBPARAGRAPH (III) OF THIS
PARAGRAPH , THE SECRETARY MAY ADOPT R ESTRICTIONS ON THE D ISCLOSURE OF
ABORTION CARE OR OTH ER SENSITIVE HEALTH SERVICES UNDER SUBPA RAGRAPH
(I) OF THIS PARAGRAPH TH AT ARE APPLICABLE ON LY TO DISCLOSURES BY HEALTH
INFORMATION EXCHANGE S OR ELECTRONIC HEAL TH NETWORKS TO OUT –OF–STATE
TREATING PROVIDERS , OUT–OF–STATE BUSINESS ENTIT IES, OTHER HEALTH
INFORMATION EXCHANGE S, OR OTHER ELECTRONIC HEALTH NET WORKS.
(III) ANY REGULATIONS ADOPT ED BY THE SECRETARY TO
IMPLEMENT RESTRICTIO NS ON THE DISCLOSURE OF MIFEPRISTONE DATA UND ER
SUBSECTION (B) OF THIS SECTION SHAL L APPLY TO DISCLOSUR ES OF DATA TO
RECIPIENTS LOCATED I N THE STATE AND OUTSIDE THE STATE.
4–305.
(a) This section may not be construed to impose an obligation on a health care
provider to disclose a medical record.
(b) A health care provider may disclose a medical record without the
authorization of a person in interest: WES MOORE, Governor Ch. 248
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(1) (i) To the provider’s authorized employees, agents, medical staff,
medical students, or consultants for the sole purpose of offering, providing, evaluating, or
seeking payment for health care to patients or recipients by the provider;
(ii) To the provider’s legal counsel regarding only the information in
the medical record that relates to the subject matter of the representation; or
(iii) To any provider’s insurer or legal counsel, or the authorized
employees or agents of a provider’s insurer or legal counsel, for the sole purpose of handling
a potential or actual claim against any provider if the medical record is maintained on the
claimant and relates to the subject matter of the claim;
(2) If the person given access to the medical record signs an
acknowledgment of the duty under this Act not to redisclose any patient identifying
information, to a person for:
(i) Educational or research purposes, subject to the applicable
requirements of an institutional review board;
(ii) Evaluation and management of health care delivery systems;
[or]
(iii) Accreditation of a facility by professional standard setting
entities; OR
(IV) AN OUT –OF–STATE INVESTIGATION OF LEGALLY
PROTECTED HEALTH CAR E PROVIDED IN THE STATE;
(3) Subject to the additional limitations for a medical record developed
primarily in connection with the provision of mental health services in § 4–307 of this
subtitle, to a government agency performing its lawful duties as authorized by an act of the
Maryland General Assembly or the United States Congress;
(4) Subject to the additional limitations for a medical record developed
primarily in connection with the provision of mental health services in § 4–307 of this
subtitle, to another health care provider for the sole purpose of treating the patient or
recipient on whom the medical record is kept;
(5) If a claim has been or may be filed by, or with the authorization of a
patient or recipient on behalf of the patient or recipient, for covered insureds, covered
beneficiaries, or enrolled recipients only, to third party payors and their agents, if the
payors or agents have met the applicable provisions of §§ 15–10B–01 to 15–10B–18 of the
Insurance Article, including nonprofit health service plans, health maintenance
organizations, fiscal intermediaries and carriers, the Department and its agents, the
United States Department of Health and Human Services and its agents, or any other Ch. 248 2023 LAWS OF MARYLAND
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person obligated by contract or law to pay for the health care rendered for the sole purposes
of:
(i) Submitting a bill to the third party payor;
(ii) Reasonable prospective, concurrent, or retrospective utilization
review or predetermination of benefit coverage;
(iii) Review, audit, and investigation of a specific claim for payment
of benefits; or
(iv) Coordinating benefit payments in accordance with the provisions
of the Insurance Article under more than one sickness and accident, dental, or hospital and
medical insurance policy;
(6) If a health care provider makes a professional determination that an
immediate disclosure is necessary, to provide for the emergency health care needs of a
patient or recipient;
(7) To immediate family members of the patient or any other individual
with whom the patient is known to have a close personal relationship, provided that:
(i) The disclosure is limited to information that is directly relevant
to the individual’s involvement in the patient’s health care; and
(ii) 1. If the patient is present or otherwise available before the
disclosure and has the capacity to make health care decisions:
A. The patient has been provided with an opportunity to
object to the disclosure and the patient has not objected; or
B. The health care provider reasonably infers from the
circumstances that, based on the health care provider’s professional judgment, the patient
does not object to the disclosure; or
2. If the patient is not present or otherwise available before
the disclosure is made, or providing the patient with an opportunity to object to the
disclosure is not practicable because of the patient’s incapacity or need for emergency care
or treatment, the health care provider determines, based on the health care provider’s
professional judgment, that the disclosure is in the best interests of the patient;
(8) To an appropriate organ, tissue, or eye recovery agency under the
restrictions of § 5–408 of this article for a patient whose organs and tissues may be donated
for the purpose of evaluating the patient for possible organ and tissue donation;
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(9) To the Department or an organ, tissue, or eye recovery agency
designated by the Department for the purpose of conducting death record reviews under §
19–310 of this article;
(10) Subject to subsection (c) of this section, if the purpose of the medical
record disclosure is for the coordination of services and record retention within the
Montgomery County Department of Health and Human Services; [or]
(11) To a carrier, as defined in § 15–1301 of the Insurance Article, or an
accountable care organization, as defined in § 3022 of the Patient Protection and Affordable
Care Act, for the sole purposes of enhancing or coordinating patient care, provided that:
(i) A disclosure under this item is subject to the additional
limitations in § 4–307 of this subtitle on disclosure of a medical record developed primarily
in connection with the provision of mental health services;
(ii) A medical record may be disclosed only in accordance with the
federal Health Insurance Portability and Accountability Act of 1996, any regulations
adopted under the Act, and any other applicable federal privacy laws, and disclosures under
this item may not be made in violation of the prohibited uses or disclosures under the
federal Health Insurance Portability and Accountability Act of 1996;
(iii) A disclosure under this item may not be used for underwriting or
utilization review purposes;
(iv) A health care provider that discloses a medical record in
accordance with this item shall provide a notice consistent with the requirements of 45
C.F.R. § 164.520 specifying the information to be shared, with whom it will be shared, and
the specific types of uses and disclosures that the health care provider may make in
accordance with this item;
(v) The notice required by item (iv) of this item shall include an
opportunity for the individual to opt out of the sharing of the individual’s medical record
with a carrier or an accountable care organization for the purposes identified in this item;
[and]
(vi) If a health care provider discloses medical information or medical
data to a carrier or accountable care organization through an infrastructure that provides
organizational and technical capabilities for the exchange of protected health information
among entities not under common ownership, the health care providers are subject to the
requirements of §§ 4–302.2 and 4–302.3 of this subtitle; AND
(VII) IF THE DISCLOSURE IS OF A PROTECTED SERVICES RECORD
OR A PROTECTED MEDIC ATION RECORD ABORTION CARE OR OTH ER SENSITIVE
HEALTH SERVICES INFO RMATION AS DETERMINE D BY THE SECRETARY UNDER §
4–302.5(D) OF THIS SUBTITLE , THE DISCLOSURE IS SU BJECT TO THE Ch. 248 2023 LAWS OF MARYLAND
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REQUIREMENTS FOR A PROTECTED SERV ICES RECORD AND PROT ECTED
MEDICATION RECORD UNDER § 4–302.5 OF THIS SUBTITLE; OR
(12) SUBJECT TO THE REQUIR EMENTS FOR A PROTECT ED SERVICES
RECORD AND PROTECTED MEDICATION RECORD UNDER § 4–302.5 OF THIS
SUBTITLE, TO ANOTHER HEALTH CA RE PROVIDER FOR THE SOLE PURPOSE OF
TREATING THE PATIENT FOR WHOM THE MEDICAL RECORD IS KEPT .
(c) (1) The disclosure of medical records under subsection (b)(10) of this
section to a person that is not employed by or under contract with the Montgomery County
Department of Health and Human Services shall be conducted in accordance with this
subtitle.
(2) Under provisions of State law regarding confidentiality, the
Montgomery County Department of Health and Human Services shall be considered to be
one agency.
4–309.
(a) THIS SECTION DOES NOT APPLY TO A VIOLATION OF § 4–302.5 OF THIS
SUBTITLE.
(B) If a health care provider knowingly refuses to disclose a medical record within
a reasonable time but no more than 21 working days after the date a person in interest
requests the disclosure, the health care provider is liable for actual damages.
[(b)] (C) A health care provider may not refuse to disclose a medical record on
the request of a person in interest because of the failure of the person in interest to pay for
health care rendered by the health care provider.
[(c)] (D) A health care provider or any other person is in violation of this subtitle
if the health care provider or any other person:
(1) Requests or obtains a medical record under false pretenses or through
deception; or
(2) Discloses a medical record in violation of this subtitle.
[(d)] (E) Except as otherwise provided in subsection [(e)] (F) of this section, a
health care provider or any other person, including an officer or employee of a governmental
unit, who knowingly and willfully violates any provision of this subtitle is guilty of a
misdemeanor and on conviction is subject to a fine not exceeding $1,000 for the first offense
and not exceeding $5,000 for each subsequent conviction for a violation of any provision of
this subtitle.
WES MOORE, Governor Ch. 248
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[(e)] (F) (1) A health care provider or any other person, including an officer
or employee of a governmental unit, who knowingly and willfully requests or obtains a
medical record under false pretenses or through deception or knowingly and willfully
discloses a medical record in violation of this subtitle is guilty of a misdemeanor and on
conviction is subject to the following penalties:
(i) A fine not exceeding $50,000, imprisonment for not more than 1
year, or both;
(ii) If the offense is committed under false pretenses, a fine not
exceeding $100,000, imprisonment for not more than 5 years, or both; and
(iii) If the offense is committed with intent to sell, transfer, or use
individually identifiable health information for commercial advantage, personal gain, or
malicious harm, a fine not exceeding $250,000, imprisonment for not more than 10 years,
or both.
(2) This subsection does not apply to an officer or employee of a
governmental unit that is conducting a criminal investigation.
[(f)] (G) A health care provider or any other person who knowingly violates any
provision of this subtitle is liable for actual damages.
4–310.
(A) THERE IS A PROTECTED HEALTH CARE COMMISSION.
(B) THE PURPOSE OF THE COMMISSION IS TO MAKE RECOMMENDATIONS
TO THE SECRETARY REGARDING S ENSITIVE HEALTH SERV ICES THAT SHOULD BE
DETERMINED BY THE SECRETARY TO BE LEGAL LY PROTECTED HEALTH CARE
UNDER THIS SUBTITLE.
(C) THE COMMISSION CONSISTS O F THE FOLLOWING MEMB ERS:
(1) THE ATTORNEY GENERAL OR THE ATTORNEY GENERAL’S
DESIGNEE;
(2) THE EXECUTIVE DIRECTOR OF THE MARYLAND HEALTH CARE
COMMISSION OR THE EXECUTIVE DIRECTOR’S DESIGNEE; AND
(3) THE FOLLOWING MEMBERS APPOINTED BY THE SECRETARY:
(I) A RESIDENT OF THE STATE WHO IS A LICENS ED PHYSICIAN
AND NOMINATED BY THE AMERICAN COLLEGE OF OBSTETRICIANS AND
GYNECOLOGISTS ; Ch. 248 2023 LAWS OF MARYLAND
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(II) A RESIDENT OF THE STATE WHO IS A LICENS ED CLINICIAN
WHO PROVIDE S REPRODUCTIVE HEALT H CARE AND NOMINATED BY THE
REPRODUCTIVE HEALTH ACCESS PROJECT;
(III) A RESIDENT OF THE STATE WHO IS A CERTIF IED
NURSE–MIDWIFE NOMINATED BY THE MARYLAND AFFILIATE OF THE AMERICAN
COLLEGE OF NURSE MIDWIVES;
(IV) A RESIDENT OF THE STATE WHO IS A REPRES ENTATIVE OF
PHYSICIANS FOR REPRODUCTIVE HEALTH;
(VI) TWO RESIDENTS OF THE STATE WHO ARE CONSUME R
REPRESENTATIVES WITH EXPERTISE IN CONSUME R DATA PRIVACY; AND
(VII) A RESIDENT OF THE STATE WITH EXPERTISE IN HEALTH
INFORMATIO N.
(D) THE COMMISSION SHALL :
(1) SELECT A CHAIR OF THE COMMISSION EACH YEAR ; AND
(2) MEET AT LEAST FOUR TI MES A YEAR.
(E) THE DEPARTMENT SHALL PROV IDE STAFF FOR THE COMMISSION.
(F) (1) THE COMMISSION SHALL IDEN TIFY SENSITIVE HEALT H SERVICES
INFORMATION BY DIAGNOSI S, PROCEDURAL , MEDICATION, OR RELATED CODES FOR
WHICH DISCLOSURE BY A HEALTH INFORMATION EXCHANGE OR ELECTRON IC
HEALTH NETWORK TO A TREATING PROVIDER , BUSINESS ENTITY , ANOTHER HEALTH
INFORMATION EXCHANGE , OR ANOTHER ELECTRONI C HEALTH NE TWORK WOULD
CREATE A SUBSTANTIAL RISK TO PATIENTS OR HEALTH CARE PROVIDER S.
(2) IN CARRYING OUT ITS W ORK, THE COMMISSION MAY CONSUL T
WITH:
(I) ORGANIZATIONS WITH EX PERTISE IN LEGAL ISS UES
IMPACTING PROVIDERS OF LEGALLY PROTECTED HEALTH CARE ;
(II) ORGANIZATIONS WITH EX PERTISE IN CONSUMER HEALTH
PRIVACY;
(III) ORGANIZATIONS WITH EX PERTISE IN HEALTH
INFORMATION TECHNOLO GY; AND WES MOORE, Governor Ch. 248
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(IV) OTHER ORGANIZATIONS W ITH CLINICAL, POLICY, OR LEGAL
EXPERTISE RELATED TO THE WORK OF THE COMMISSION.
(G) (1) THE COMMISSION SHALL ISSU E SEMIANNUAL REPORTS TO THE
SECRETARY ON RECOMMEN DATIONS REGARDING SE NSITIVE HEALTH SERVI CES
THAT SHOULD BE DETER MINED BY THE SECRETARY TO BE LEGAL LY PROTECTED
HEALTH CARE UNDER TH IS SUBTITLE OR FOR W HICH THE SECRETARY SHOULD
RESCIND A PREVIOUS DE TERMINATION .
(2) THE REPORTS SHALL INC LUDE AN ASSESSMENT O F THE
POTENTIAL RISK TO PA TIENTS AND HEALTH CA RE PROVIDERS THAT WO ULD RESULT
FROM THE DISCLOSURE OF THE SENSITIVE HEA LTH SERVICES THAT AR E
ADDRESSED IN THE REP ORTS.
(3) WITHIN 60 DAYS AFTER RECEIVING A SEMIANNUAL REPORT
UNDER PARAGRAPH (1) OF THIS SUBSECTION , THE SECRETARY SHALL SUBMI T A
WRITTEN RESPONSE TO THE REPORT THAT INCL UDES THE FINDINGS AN D
DETERMINATIONS OF TH E SECRETARY TO:
(I) THE COMMISSION; AND
(II) IN ACCORDANCE WITH § 2–1257 OF THE STATE
GOVERNMENT ARTICLE, THE SENATE FINANCE COMMITTEE AND THE HOUSE
HEALTH AND GOVERNMENT OPERATIONS COMMITTEE.
19–103.
(a) There is a Maryland Health Care Commission.
(b) The Commission is an independent commission th at functions in the
Department.
(c) The purpose of the Commission is to:
(1) Develop health care cost containment strategies to help provide access
to appropriate quality health care services for all Marylanders, after consulting with the
Health Services Cost Review Commission;
(2) Promote the development of a health regulatory system that provides,
for all Marylanders, financial and geographic access to quality health care services at a
reasonable cost by:
(i) Advocating policies and systems to promote the efficient delivery
of and improved access to health care services; and Ch. 248 2023 LAWS OF MARYLAND
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(ii) Enhancing the strengths of the current health care service
delivery and regulatory system;
(3) Facilitate the public disclosure of medical claims data for the
development of public policy;
(4) Establish and develop a medical care database on health care services
rendered by health care practitioners;
(5) Encourage the development of clinical resource management systems
to permit the comparison of costs between various treatment settings and the availability
of information to consumers, providers, and purchasers of health care services;
(6) In accordance with Title 15, Subtitle 12 of the Insurance Article,
develop a uniform set of effective benefits to be included in the Comprehensive Standard
Health Benefit Plan;
(7) Analyze the medical care database and provide, in aggregate form, an
annual report on the variations in costs associated with health care practitioners;
(8) Ensure utilization of the medical care database as a primary means to
compile data and information and annually report on trends and variances regarding fees
for service, cost of care, regional and national comparisons, and indications of malpractice
situations;
(9) Establish standards for the operation and licensing of medical care
electronic claims clearinghouses in Maryland;
(10) Reduce the costs of claims submission and the administration of claims
for health care practitioners and payors;
(11) Determine the cost of mandated health insurance services in the State
in accordance with Title 15, Subtitle 15 of the Insurance Article;
(12) Promote the availability of information to consumers on charges by
practitioners and reimbursements from payors; [and]
(13) Oversee and administer the Maryland Trauma Physician Services
Fund in conjunction with the Health Services Cost Review Commission; AND
(14) ESTABLISH POLICIES AN D STANDARDS TO PROTE CT THE
CONFIDENTIALITY OF P ATIENT AND HEALTH CA RE PRACTITIONER INFO RMATION
RELATED TO LEGALLY PROT ECTED HEALTH CARE AS DEFINED IN § 4–301 OF THIS
ARTICLE.
WES MOORE, Governor Ch. 248
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(d) The Commission shall coordinate the exercise of its functions with the
Department and the Health Services Cost Review Commission to ensure an integrated,
effective health care policy for the State.
19–145.
(a) (1) In this section the following words have the meanings indicated.
(2) “Dispenser” means a person authorized by law to dispense, as defined
in § 12–101 of the Health Occupations Article, a prescription drug to a patient or the
patient’s agent in the State.
(3) “Noncontrolled prescription drug” means a prescription drug, as
defined in § 21–201 of this article, that is not a controlled dangerous substance designated
under Title 5, Subtitle 4 of the Criminal Law Article.
(4) “State designated exchange” has the meaning stated in § 4–302.3 of this
article.
(b) The State designated exchange shall operate as a health data utility for the
State.
(c) The purposes of the health data utility include:
(1) The collection, aggregation, and analysis of clinical information, public
health data, and health administrative and operations data to assist the Department, local
health departments, the Commission, and the Health Services Cost Review Commission in
the evaluation of public health interventions and health equity;
(2) The communication of data between public health officials and health
care providers to advance disease control and health equity; and
(3) The enhancement and acceleration of the interoperability of health
information throughout the State.
(d) [Dispensers] EXCEPT AS PROVIDED IN SUBSECTION (E) OF THIS
SECTION, EACH DISPENSER shall provide data to the State designated exchange.
(E) (1) A DISPENSER MAY NOT SU BMIT INFORMATION ON MIFEPRISTONE ,
MISOPROSTOL , OR ANY MEDICATION US ED FOR A MEDICAL ABO RTION, AS
DETERMINED BY THE SECRETARY, TO THE STATE DESIGNATED EXCH ANGE.
(2) THE SECRETARY SHALL FOLLO W GUIDELINES OF THE AMERICAN
COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS , THE WORLD HEALTH
ORGANIZATION, AND THE SOCIETY OF FAMILY PLANNING IN DETERMINI NG THE
MEDICATIONS TO BE IN CLUDED AMONG THE MED ICATIONS USED IN A M EDICAL Ch. 248 2023 LAWS OF MARYLAND
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ABORTION ABOUT WHICH A DISPENSER MAY NOT SUBMIT INFORMATION U NDER
PARAGRAPH (1) OF THIS SUBSECTION .
[(e)] (F) (1) The purpose of this subsection is to:
(i) Authorize individuals and organizations involved in the
treatment and care coordination of patients to access, as legally authorized, a patient’s
medication history, including medications prescribed for the patient; and
(ii) Assist health care providers, care managers, the Department,
and local health departments to understand and promote matters of health equity and
treatment efficacy.
(2) After dispensing a noncontrolled prescription drug OTHER THAN THE
MEDICAL AB ORTION MEDICATIONS D ESCRIBED UNDER SUBSE CTION (E) OF THIS
SECTION, a dispenser shall submit prescription information to the State designated
exchange.
(3) The prescription information shall be submitted:
(i) By electronic means;
(ii) Without unduly increasing the workload and expense on a
dispenser;
(iii) In a manner that minimizes burden and duplication by being as
compatible as possible with existing federal standards for data submission practices,
including technology software of dispensers; and
(iv) As otherwise required by regulations adopted by the
Commission.
(4) The State designated exchange may not impose any fees or other
assessments on dispensers to support the operation of the exchange.
(5) The State designated exchange shall make prescription information
submitted under this subsection available for purposes of treatment and care coordination
of a patient.
[(f)] (G) The State designated exchange may provide data, as allowed by law, for
public health purposes that may include:
(1) Improving health equity through access to prescription medications,
including for the treatment of infectious disease;
WES MOORE, Governor Ch. 248
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(2) Assisting programs led by health care providers and the Department,
local health departments, the Commission, and the Health Services Cost Review
Commission to identify opportunities for quality improvement, including for stewardship
of antibiotic medications; and
(3) Conducting case investigations and related activities.
[(g)] (H) Information submitted to the State information exchange or provided
by the State information exchange under this section shall be submitted or provided, to the
extent practicable, in as near to real time as possible.
[(h)] (I) (1) The Commission, in consultation with appropriate stakeholders,
shall adopt regulations to carry out this section.
(2) The regulations shall take into account consumer perspective and
include:
(i) The specific data required to be provided under subsection (d) of
this section;
(ii) The specific prescription information required to be submitted
under subsection [(e)] (F) of this section;
(iii) The time frame for submitting prescription information under
subsection [(e)] (F) of this section;
(iv) The electronic means and manner by which pre scription
information is to be submitted under subsection [(e)] (F) of this section;
(v) Prescription information submission requirements that align
with the data submission requirements on dispensers of monitored prescription drugs
under Title 21, Subtitle 2A of this article; and
(vi) Identification and necessary suppression of information related
to providers or medications that are determined to have significant potential to cause harm.
[(i)] (J) (1) The State designated exchange shall establish a consumer
advisory council to bring the perspectives of individuals and organizations with an interest
in protecting consumers into the delivery of services provided by the State designated
exchange.
(2) In selecting members, the State designated exchange shall consider
diversity of experience.
(3) The consumer advisory council established under paragraph (1) of this
subsection shall: Ch. 248 2023 LAWS OF MARYLAND
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(i) Consist of a minimum of six members, including at least four
consumer representatives and two staff representatives, and maintain a ratio of consumer
representatives to nonconsumer representatives of at least two to one;
(ii) Identify and report consumer privacy concerns to senior
leadership of the State designated exchange;
(iii) Advise on efforts to educate consumers on data exchange policies,
including options for consumers to opt out of disclosure of protected health information;
(iv) Meet at least 3 times each year; and
(v) Adopt and maintain a charter to be posted online that includes
the purpose, members, and meeting schedule of the consumer advisory council.
Article – Insurance
15–857.
(a) (1) This section applies to:
(i) insurers and nonprofit health service plans that provide labor
and delivery coverage to individuals or groups on an expense–incurred basis under health
insurance policies or contracts that are issued or delivered in the State; and
(ii) health maintenance organizations that provide labor and
delivery coverage to individuals or groups under contracts that are issued or delivered in
the State.
(2) This section does not apply to:
(i) a multistate plan that does not provide coverage for abortions in
accordance with 42 U.S.C. § 18054(a)(6); or
(ii) a high–deductible plan, as defined in 26 U.S.C. § 223(c)(2)(C) of
the Internal Revenue Code, unless the Commissioner determines that abortion care is not
excluded from the safe harbor provisions for preventive care under § 223(c)(2)(C) of the
Internal Revenue Code.
(3) An organization that is eligible to obtain an exclusion from the coverage
requirements under § 15–826 of this subtitle may obtain from an entity subject to this
section an exclusion from the coverage and notice requirements of this section if the
requirements conflict with the organization’s bona fide religious beliefs and practices.
WES MOORE, Governor Ch. 248
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(b) Except as provided in subsection (c) of this section AND NOTWITHSTANDING
§ 31–116(A) OF THIS ARTICLE , an entity subject to this section shall:
(1) cover abortion care services without:
(i) a deductible, coinsurance, copayment, or any other cost–sharing
requirement; and
(ii) restrictions that are inconsistent with the protected rights under
Title 20, Subtitle 2 of the Health – General Article; and
(2) provide information to consumers about abortion care coverage using
the terminology “abortion care” to describe coverage.
(c) If the Commissioner determines that enforcement of this section may
adversely affect the allocation of federal funds to the State, the Commissioner may grant
an exemption to the requirements of this section to the minimum extent necessary to
ensure the continued receipt of federal funds.
31–116.
(a) The essential health benefits required under § 1302(a) of the Affordable Care
Act:
(1) shall be the benefits in the State benchmark plan, selected in
accordance with this section; and
(2) notwithstanding any other benefits mandated by State law, shall be the
benefits required in:
(i) subject to subsection (f) of this section, all individual health
benefit plans and health benefit plans offered to small employers, except for grandfathered
health plans, as defined in the Affordable Care Act, offered outside the Exchange; and
(ii) subject to § 31–115(c) of this subtitle, all qualified health plans
offered in the Exchange.
SECTION 2. AND BE IT FURTHER ENACTED, That the Secretary of Health shall
adopt emergency regulations within 90 days after the effective date of this Act to identify
diagnostic, procedure, medication, and related codes for abortion care in accordance with §
4–302.5 of the Health – General Article, as enacted by Section 1 of this Act.
SECTION 3. AND BE IT FURTHER ENACTED, That the Maryland Health Care
Commission shall adopt emergency regulations within 9 months after the effective date of
this Act to implement § 4–302.5 of the Health – General Article, as enacted by Section 1 of
this Act. Ch. 248 2023 LAWS OF MARYLAND
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SECTION 4. AND BE IT FURTHER ENACTED, That, in fiscal years 2024 and 2025,
the Maryland Health Care Commission shall report on a quarterly basis to the Senate
Finance Committee and the House Health and Government Operations Committee, in
accordance with § 2–1257 of the State Government Article, on the status of the
implementation of § 4–302.5 of the Health – General Article, as enacted by Section 1 of this
Act.
SECTION 2. 5. AND BE IT FURTHER ENACTED, That this Act shall take effect
October June 1, 2023.
Approved by the Governor, May 3, 2023.