EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0986*
HOUSE BILL 986
J1 4lr2993
CF SB 594
By: Delegate R. Lewis
Introduced and read first time: February 5, 2024
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Maryland Medical Assistance Program – Coverage for the Treatment of Obesity 2
FOR the purpose of requiring, beginning on a certain date, the Maryland Medical 3
Assistance Program to provide comprehensive coverage for the treatment of obesity; 4
requiring the Maryland Department of Health to provide notice to Program 5
recipients of the coverage requirements; and generally relating to the Maryland 6
Medical Assistance Program and coverage for the treatment of obesity. 7
BY repealing and reenacting, without amendments, 8
Article – Health – General 9
Section 15–103(a)(1) 10
Annotated Code of Maryland 11
(2023 Replacement Volume) 12
BY repealing and reenacting, with amendments, 13
Article – Health – General 14
Section 15–103(a)(2)(xxi) and (xxii) 15
Annotated Code of Maryland 16
(2023 Replacement Volume) 17
(As enacted by Chapters 504 and 505 of the Acts of the General Assembly of 2022) 18
BY adding to 19
Article – Health – General 20
Section 15–103(a)(2)(xxiii) and 15–155 21
Annotated Code of Maryland 22
(2023 Replacement Volume) 23
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 24
That the Laws of Maryland read as follows: 25
Article – Health – General 26 2 HOUSE BILL 986
15–103. 1
(a) (1) The Secretary shall administer the Maryland Medical Assistance 2
Program. 3
(2) The Program: 4
(xxi) Beginning on January 1, 2024, shall provide gender–affirming 5
treatment in accordance with § 15–151 of this subtitle; [and] 6
(xxii) Beginning on July 1, 2025, shall provide, subject to the 7
limitations of the State budget, and as permitted by federal law, coverage for biomarker 8
testing in accordance with § 15–859 of the Insurance Article; AND 9
(XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE 10
COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE 11
WITH § 15–155 OF THIS SUBTITLE. 12
15–155. 13
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 14
INDICATED. 15
(2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY” 16
INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY , 17
AND FDA–APPROVED ANTIOBESITY MEDICATION. 18
(3) “FDA–APPROVED ANTIOBESITY MEDICATION” MEANS ANY 19
MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH 20
AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY. 21
(B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COV ERAGE FOR THE 22
TREATMENT OF OBESITY . 23
(C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY 24
MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE 25
THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR 26
TREATMENT . 27
(D) THE PROGRAM MAY UNDERTAKE UTILIZATIO N MANAGEMENT TO 28
DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF 29
OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME 30 HOUSE BILL 986 3
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 1
ILLNESS, CONDITION, OR DISORDER COVERED BY THE PROGRAM. 2
(E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS 3
OF THE COVERAGE REQU IRED UNDER THIS SECT ION. 4
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025, 5
the Maryland Department of Health shall provide notice to Maryland Medical Assistance 6
Program recipients of the coverage required by this Act in writing, and prominently 7
positioned in any literature or correspondence sent to Program recipients about coverage 8
available under the Program in calendar year 2025. 9
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 10
October 1, 2024. 11