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.
*sb0594*
SENATE BILL 594
J1 4lr2165
CF HB 986
By: Senator Hershey
Introduced and read first time: January 26, 2024
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 2, 2024
CHAPTER ______
AN ACT concerning 1
Maryland Medical Assistance Program – Coverage for the Treatment of Obesity 2
– 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 SENATE BILL 594
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, in consultation with relev ant 15
stakeholders, including representatives of the American Board of Obesity Medicine, the 16
Johns Hopkins University School of Medicine, and the University of Maryland School of 17
Medicine, shall study the impact of requiring the Maryland Medical Assistance Program to 18
provide comprehensive coverage for the treatment of obesity. 19
(c) In conducting the study, the Department shall: 20
(1) identify and compare the coverage for the treatment of obesity under 21
medical assistance programs and other public health programs in other states; and 22
(2) examine and estimate any potential savings that may result from 23
requiring comprehensive coverage for the treatment of obesity due to reductions in the use 24
of medications and services currently covered under the Maryland Medical Assistance 25
Program, including reductions in costs from weight–related comorbidities including 26
cardiovascular disease, hypertension, sleep apnea, depression, asthma, nonalcoholic fatty 27
liver disease, Type 2 diabetes, knee and hip osteoarthritis, and gout. 28
(d) On or before December 31, 2024, the Maryland Department of Health shall 29
report its findings to the House Health and Government Operations Committee and the 30
Senate Finance Committee, in accordance with § 2–1257 of the State Government Article. 31
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 32
That the Laws of Maryland read as follows: 33
Article – Health – General 34
15–103. 35 SENATE BILL 594 3
(a) (1) The Secretary shall administer the Maryland Medical Assistance 1
Program. 2
(2) The Program: 3
(xxi) Beginning on January 1, 2024, shall provide gender–affirming 4
treatment in accordance with § 15–151 of this subtitle; [and] 5
(xxii) Beginning on July 1, 2025, shall provide, subject to the 6
limitations of the State budget, and as permitted by federal law, coverage for biomarker 7
testing in accordance with § 15–859 of the Insurance Article; AND 8
(XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE 9
COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE 10
WITH § 15–155 OF THIS SUBTITLE . 11
15–155. 12
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 13
INDICATED. 14
(2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY” 15
INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY , 16
AND FDA–APPROVED ANTIOBESITY MEDICATION. 17
(3) “FDA–APPROVED ANTIOBESITY M EDICATION” MEANS ANY 18
MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH 19
AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY. 20
(B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE 21
TREATMENT OF OBESITY. 22
(C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY 23
MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE 24
THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR 25
TREATMENT . 26
(D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO 27
DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF 28
OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME 29
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 30
ILLNESS, CONDITION, OR DISORDER COVERE D BY THE PROGRAM. 31
4 SENATE BILL 594
(E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS 1
OF THE COVERAGE REQU IRED UNDER THIS SECT ION. 2
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025, 3
the Maryland Department of Health shall provide notice to Maryland Medical Assistance 4
Program recipients of the coverage required by this Act in writing, and prominently 5
positioned in any literature or correspondence sent to Program recipients about coverage 6
available under the Program in calendar year 2025. 7
SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 8
October July 1, 2024. 9
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.