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Maryland House Bill HB986

Maryland 2024 Regular Session

Maryland House Bill HB986 Compare Versions

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1- WES MOORE, Governor Ch. 777
21
3-– 1 –
4-Chapter 777
5-(House Bill 986)
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+ *hb0986*
89
9-Maryland Medical Assistance Program – Coverage for the Treatment of
10-Obesity – Required Study
10+HOUSE BILL 986
11+J1 4lr2993
12+ CF SB 594
13+By: Delegate R. Lewis
14+Introduced and read first time: February 5, 2024
15+Assigned to: Health and Government Operations
16+Committee Report: Favorable with amendments
17+House action: Adopted
18+Read second time: March 20, 2024
1119
12-FOR the purpose of requiring the Maryland Department of Health to study the impact of
13-requiring the Maryland Medical Assistance Program to provide comprehensive
14-coverage for the treatment of obesity; and generally relating to a study of coverage
15-for the treatment of obesity. requiring, beginning on a certain date, the Maryland
16-Medical Assistance Program to provide comprehensive coverage for the treatment of
17-obesity; requiring the Maryland Department of Health to provide notice to Program
18-recipients of the coverage requirements; and generally relating to the Maryland
19-Medical Assistance Program and coverage for the treatment of obesity.
20+CHAPTER ______
2021
21-BY repealing and reenacting, without amendments,
22- Article – Health – General
23-Section 15–103(a)(1)
24- Annotated Code of Maryland
25- (2023 Replacement Volume)
22+AN ACT concerning 1
2623
27-BY repealing and reenacting, with amendments,
28- Article – Health – General
29-Section 15–103(a)(2)(xxi) and (xxii)
30- Annotated Code of Maryland
31- (2023 Replacement Volume)
32- (As enacted by Chapters 504 and 505 of the Acts of the General Assembly of 2022)
24+Maryland Medical Assistance Program – Coverage for the Treatment of 2
25+Obesity – Required Study 3
3326
34-BY adding to
35- Article – Health – General
36-Section 15–103(a)(2)(xxiii) and 15–155
37- Annotated Code of Maryland
38- (2023 Replacement Volume)
27+FOR the purpose of requiring the Maryland Department of Health to study the impact of 4
28+requiring the Maryland Medical Assistance Program to provide comprehensive 5
29+coverage for the treatment of obesity; and generally relating to a study of coverage 6
30+for the treatment of obesity. requiring, beginning on a certain date, the Maryland 7
31+Medical Assistance Program to provide comprehensive coverage for the treatment of 8
32+obesity; requiring the Maryland Department of Health to provide notice to Program 9
33+recipients of the coverage requirements; and generally relating to the Maryland 10
34+Medical Assistance Program and coverage for the treatment of obesity. 11
3935
40- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
41-That:
36+BY repealing and reenacting, without amendments, 12
37+ Article – Health – General 13
38+Section 15–103(a)(1) 14
39+ Annotated Code of Maryland 15
40+ (2023 Replacement Volume) 16
4241
43- (a) (1) In this section the following words have the meanings indicated.
42+BY repealing and reenacting, with amendments, 17
43+ Article – Health – General 18
44+Section 15–103(a)(2)(xxi) and (xxii) 19
45+ Annotated Code of Maryland 20
46+ (2023 Replacement Volume) 21
47+ (As enacted by Chapters 504 and 505 of the Acts of the General Assembly of 2022) 22
48+ 2 HOUSE BILL 986
4449
45- (2) “Comprehensive coverage for the treatment of obesity” includes
46-coverage for intensive behavioral therapy, bariatric surgery, and FDA –approved
47-antiobesity medication.
48- Ch. 777 2024 LAWS OF MARYLAND
4950
50-– 2 –
51- (3) “FDA–approved antiobesity medication” means any medication
52-approved by the federal Food and Drug Administration with an indication for chronic
53-weight management in patients with obesity.
51+BY adding to 1
52+ Article – Health – General 2
53+Section 15–103(a)(2)(xxiii) and 15–155 3
54+ Annotated Code of Maryland 4
55+ (2023 Replacement Volume) 5
5456
55- (b) The Maryland Department of Health shall study the impact of requiring the
56-Maryland Medical Assistance Program to provide comprehensive coverage for the
57-treatment of obesity.
57+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
58+That: 7
5859
59- (c) In conducting the study, the Department shall:
60+ (a) (1) In this section the following words have the meanings indicated. 8
6061
61- (1) identify and compare the coverage for the treatment of obesity under
62-medical assistance programs and other public health programs in other states; and
62+ (2) “Comprehensive coverage for the treatment of obesity” includes 9
63+coverage for intensive behavioral therapy, bariatric surgery, and FDA –approved 10
64+antiobesity medication. 11
6365
64- (2) examine and estimate any potential savings that may result from
65-requiring comprehensive coverage for the treatment of obesity.
66+ (3) “FDA–approved antiobesity medication” means any medication 12
67+approved by the federal Food and Drug Administration with an indication for chronic 13
68+weight management in patients with obesity. 14
6669
67- (d) On or before December 31, 2024, the Maryland Department of Health shall
68-report its findings to the House Health and Government Operations Committee and the
69-Senate Finance Committee, in accordance with § 2–1257 of the State Government Article.
70+ (b) The Maryland Department of Health shall study the impact of requiring the 15
71+Maryland Medical Assistance Program to provide comprehensive coverage for the 16
72+treatment of obesity. 17
7073
71- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
72-That the Laws of Maryland read as follows:
74+ (c) In conducting the study, the Department shall: 18
7375
74-Article – Health – General
76+ (1) identify and compare the coverage for the treatment of obesity under 19
77+medical assistance programs and other public health programs in other states; and 20
7578
76-15–103.
79+ (2) examine and estimate any potential savings that may result from 21
80+requiring comprehensive coverage for the treatment of obesity. 22
7781
78- (a) (1) The Secretary shall administer the Maryland Medical Assistance
79-Program.
82+ (d) On or before December 31, 2024, the Maryland Department of Health shall 23
83+report its findings to the House Health and Government Operations Committee and the 24
84+Senate Finance Committee, in accordance with § 2–1257 of the State Government Article. 25
8085
81- (2) The Program:
86+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
87+That the Laws of Maryland read as follows: 27
8288
83- (xxi) Beginning on January 1, 2024, shall provide gender–affirming
84-treatment in accordance with § 15–151 of this subtitle; [and]
89+Article – Health – General 28
8590
86- (xxii) Beginning on July 1, 2025, shall provide, subject to the
87-limitations of the State budget, and as permitted by federal law, coverage for biomarker
88-testing in accordance with § 15–859 of the Insurance Article; AND
91+15–103. 29
8992
90- (XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE
91-COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE
92-WITH § 15–155 OF THIS SUBTITLE .
93+ (a) (1) The Secretary shall administer the Maryland Medical Assistance 30
94+Program. 31
9395
94-15–155.
95- WES MOORE, Governor Ch. 777
96+ (2) The Program: 32
97+ HOUSE BILL 986 3
9698
97-– 3 –
98- (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS
99-INDICATED.
10099
101- (2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY”
102-INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY ,
103-AND FDA–APPROVED ANTIOBESITY MEDICATION.
100+ (xxi) Beginning on January 1, 2024, shall provide gender–affirming 1
101+treatment in accordance with § 15–151 of this subtitle; [and] 2
104102
105- (3) “FDA–APPROVED ANTIOBESITY MEDICATION” MEANS ANY
106-MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH
107-AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY.
103+ (xxii) Beginning on July 1, 2025, shall provide, subject to the 3
104+limitations of the State budget, and as permitted by federal law, coverage for biomarker 4
105+testing in accordance with § 15–859 of the Insurance Article; AND 5
108106
109- (B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE
110-TREATMENT OF OBESITY .
107+ (XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE 6
108+COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE 7
109+WITH § 15–155 OF THIS SUBTITLE . 8
111110
112- (C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY
113-MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE
114-THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR
115-TREATMENT .
111+15–155. 9
116112
117- (D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO
118-DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF
119-OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME
120-MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER
121-ILLNESS, CONDITION, OR DISORDER COVERE D BY THE PROGRAM.
113+ (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 10
114+INDICATED. 11
122115
123- (E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS
124-OF THE COVERAGE REQU IRED UNDER THIS SECT ION.
116+ (2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY” 12
117+INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY , 13
118+AND FDA–APPROVED ANTIOBESITY MEDICATION. 14
125119
126- SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025,
127-the Maryland Department of Health shall provide notice to Maryland Medical Assistance
128-Program recipients of the coverage required by this Act in writing, and prominently
129-positioned in any literature or correspondence sent to Program recipients about coverage
130-available under the Program in calendar year 2025.
120+ (3) “FDA–APPROVED ANTIOBESITY MEDICATION” MEANS ANY 15
121+MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH 16
122+AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY. 17
131123
132- SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
133-October July 1, 2024.
124+ (B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE 18
125+TREATMENT OF OBESITY . 19
134126
135-Approved by the Governor, May 16, 2024.
127+ (C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY 20
128+MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE 21
129+THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR 22
130+TREATMENT . 23
131+
132+ (D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO 24
133+DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF 25
134+OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME 26
135+MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 27
136+ILLNESS, CONDITION, OR DISORDER C OVERED BY THE PROGRAM. 28
137+
138+ (E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS 29
139+OF THE COVERAGE REQU IRED UNDER THIS SECT ION. 30
140+
141+ SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025, 31
142+the Maryland Department of Health shall provide notice to Maryland Medical Assistance 32
143+Program recipients of the coverage required by this Act in writing, and prominently 33 4 HOUSE BILL 986
144+
145+
146+positioned in any literature or correspondence sent to Program recipients about coverage 1
147+available under the Program in calendar year 2025. 2
148+
149+ SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
150+October July 1, 2024. 4
151+
152+
153+
154+
155+
156+Approved:
157+________________________________________________________________________________
158+ Governor.
159+________________________________________________________________________________
160+ Speaker of the House of Delegates.
161+________________________________________________________________________________
162+ President of the Senate.