EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*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
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 20, 2024
CHAPTER ______
AN ACT concerning 1
Maryland Medical Assistance Program – Coverage for the Treatment of 2
Obesity – Required Study 3
FOR the purpose of requiring the Maryland Department of Health to study the impact of 4
requiring the Maryland Medical Assistance Program to provide comprehensive 5
coverage for the treatment of obesity; and generally relating to a study of coverage 6
for the treatment of obesity. requiring, beginning on a certain date, the Maryland 7
Medical Assistance Program to provide comprehensive coverage for the treatment of 8
obesity; requiring the Maryland Department of Health to provide notice to Program 9
recipients of the coverage requirements; and generally relating to the Maryland 10
Medical Assistance Program and coverage for the treatment of obesity. 11
BY repealing and reenacting, without amendments, 12
Article – Health – General 13
Section 15–103(a)(1) 14
Annotated Code of Maryland 15
(2023 Replacement Volume) 16
BY repealing and reenacting, with amendments, 17
Article – Health – General 18
Section 15–103(a)(2)(xxi) and (xxii) 19
Annotated Code of Maryland 20
(2023 Replacement Volume) 21
(As enacted by Chapters 504 and 505 of the Acts of the General Assembly of 2022) 22
2 HOUSE BILL 986
BY adding to 1
Article – Health – General 2
Section 15–103(a)(2)(xxiii) and 15–155 3
Annotated Code of Maryland 4
(2023 Replacement Volume) 5
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That: 7
(a) (1) In this section the following words have the meanings indicated. 8
(2) “Comprehensive coverage for the treatment of obesity” includes 9
coverage for intensive behavioral therapy, bariatric surgery, and FDA –approved 10
antiobesity medication. 11
(3) “FDA–approved antiobesity medication” means any medication 12
approved by the federal Food and Drug Administration with an indication for chronic 13
weight management in patients with obesity. 14
(b) The Maryland Department of Health shall study the impact of requiring the 15
Maryland Medical Assistance Program to provide comprehensive coverage for the 16
treatment of obesity. 17
(c) In conducting the study, the Department shall: 18
(1) identify and compare the coverage for the treatment of obesity under 19
medical assistance programs and other public health programs in other states; and 20
(2) examine and estimate any potential savings that may result from 21
requiring comprehensive coverage for the treatment of obesity. 22
(d) On or before December 31, 2024, the Maryland Department of Health shall 23
report its findings to the House Health and Government Operations Committee and the 24
Senate Finance Committee, in accordance with § 2–1257 of the State Government Article. 25
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
That the Laws of Maryland read as follows: 27
Article – Health – General 28
15–103. 29
(a) (1) The Secretary shall administer the Maryland Medical Assistance 30
Program. 31
(2) The Program: 32
HOUSE BILL 986 3
(xxi) Beginning on January 1, 2024, shall provide gender–affirming 1
treatment in accordance with § 15–151 of this subtitle; [and] 2
(xxii) Beginning on July 1, 2025, shall provide, subject to the 3
limitations of the State budget, and as permitted by federal law, coverage for biomarker 4
testing in accordance with § 15–859 of the Insurance Article; AND 5
(XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE 6
COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE 7
WITH § 15–155 OF THIS SUBTITLE . 8
15–155. 9
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 10
INDICATED. 11
(2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY” 12
INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY , 13
AND FDA–APPROVED ANTIOBESITY MEDICATION. 14
(3) “FDA–APPROVED ANTIOBESITY MEDICATION” MEANS ANY 15
MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH 16
AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY. 17
(B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE 18
TREATMENT OF OBESITY . 19
(C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY 20
MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE 21
THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR 22
TREATMENT . 23
(D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO 24
DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF 25
OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME 26
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 27
ILLNESS, CONDITION, OR DISORDER C OVERED BY THE PROGRAM. 28
(E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS 29
OF THE COVERAGE REQU IRED UNDER THIS SECT ION. 30
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025, 31
the Maryland Department of Health shall provide notice to Maryland Medical Assistance 32
Program recipients of the coverage required by this Act in writing, and prominently 33 4 HOUSE BILL 986
positioned in any literature or correspondence sent to Program recipients about coverage 1
available under the Program in calendar year 2025. 2
SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
October July 1, 2024. 4
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.