WES MOORE, Governor Ch. 778
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Chapter 778
(Senate Bill 594)
AN ACT concerning
Maryland Medical Assistance Program – Coverage for the Treatment of Obesity
– Required Study
FOR the purpose of requiring the Maryland Department of Health to study the impact of
requiring the Maryland Medical Assistance Program to provide comprehensive
coverage for the treatment of obesity; and generally relating to a study of coverage
for the treatment of obesity. requiring, beginning on a certain date, the Maryland
Medical Assistance Program to provide comprehensive coverage for the treatment of
obesity; requiring the Maryland Department of Health to provide notice to Program
recipients of the coverage requirements; and generally relating to the Maryland
Medical Assistance Program and coverage for the treatment of obesity.
BY repealing and reenacting, without amendments,
Article – Health – General
Section 15–103(a)(1)
Annotated Code of Maryland
(2023 Replacement Volume)
BY repealing and reenacting, with amendments,
Article – Health – General
Section 15–103(a)(2)(xxi) and (xxii)
Annotated Code of Maryland
(2023 Replacement Volume)
(As enacted by Chapters 504 and 505 of the Acts of the General Assembly of 2022)
BY adding to
Article – Health – General
Section 15–103(a)(2)(xxiii) and 15–155
Annotated Code of Maryland
(2023 Replacement Volume)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That:
(a) (1) In this section the following words have the meanings indicated.
(2) “Comprehensive coverage for the treatment of obesity” includes
coverage for intensive behavioral therapy, bariatric surgery, and FDA –approved
antiobesity medication.
Ch. 778 2024 LAWS OF MARYLAND
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(3) “FDA–approved antiobesity medication” means any medicati on
approved by the federal Food and Drug Administration with an indication for chronic
weight management in patients with obesity.
(b) The Maryland Department of Health , in consultation with relevant
stakeholders, including representatives of the American Board of Obesity Medicine, the
Johns Hopkins University School of Medicine, and the University of Maryland School of
Medicine, shall study the impact of requiring the Maryland Medical Assistance Program to
provide comprehensive coverage for the treatment of obesity.
(c) In conducting the study, the Department shall:
(1) identify and compare the coverage for the treatment of obesity under
medical assistance programs and other public health programs in other states; and
(2) examine and estimate any potential savings that may result from
requiring comprehensive coverage for the treatment of obesity due to reductions in the use
of medications and services currently covered under the Maryland Medical Assistance
Program, including reductions in costs from weight–related comorbidities including
cardiovascular disease, hypertension, sleep apnea, depression, asthma, nonalcoholic fatty
liver disease, Type 2 diabetes, knee and hip osteoarthritis, and gout.
(d) On or before December 31, 2024, the Maryland Department of Health shall
report its findings to the House Health and Government Operations Committee and the
Senate Finance Committee, in accordance with § 2–1257 of the State Government Article.
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
15–103.
(a) (1) The Secretary shall administer the Maryland Medical Assistance
Program.
(2) The Program:
(xxi) Beginning on January 1, 2024, shall provide gender–affirming
treatment in accordance with § 15–151 of this subtitle; [and]
(xxii) Beginning on July 1, 2025, shall provide, subject to the
limitations of the State budget, and as permitted by federal law, coverage for biomarker
testing in accordance with § 15–859 of the Insurance Article; AND
WES MOORE, Governor Ch. 778
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(XXIII) BEGINNING ON JULY 1, 2025, SHALL PROVIDE
COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE
WITH § 15–155 OF THIS SUBTITLE .
15–155.
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS
INDICATED.
(2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY”
INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY ,
AND FDA–APPROVED ANTIOBESITY MEDICATION.
(3) “FDA–APPROVED ANTIOBESITY MEDICATION” MEANS ANY
MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH
AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY.
(B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE
TREATMENT O F OBESITY.
(C) COVERAGE CRITERIA FOR FDA–APPROVED ANTIOBESITY
MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE
THAN THE FDA–APPROVED ANTIOBESITY MEDICATION’S INDICATIONS FOR
TREATMENT .
(D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO
DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF
OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER
ILLNESS, CONDITION, OR DISORDER COVERE D BY THE PROGRAM.
(E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS
OF THE COVERAGE REQU IRED UNDER THIS SECT ION.
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2025,
the Maryland Department of Health shall provide notice to Maryland Medical Assistance
Program recipients of the coverage required by this Act in writing, and prominently
positioned in any literature or correspondence sent to Program recipients about coverage
available under the Program in calendar year 2025.
SECTION 3. 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
October July 1, 2024.
Approved by the Governor, May 16, 2024.