MD
Maryland Senate Bill SB684

Maryland 2024 Regular Session

Maryland Senate Bill SB684 Compare Versions

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1- WES MOORE, Governor Ch. 233
21
3-– 1 –
4-Chapter 233
5-(Senate Bill 684)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING 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+ *sb0684*
89
9-Health Insurance – Mental Health and Substance Use Disorder Benefits –
10-Sunset Repeal and Modification of Reporting Requirements
10+SENATE BILL 684
11+J5 EMERGENCY BILL 4lr2261
12+ CF HB 1074
13+By: Senator Augustine
14+Introduced and read first time: January 29, 2024
15+Assigned to: Finance
16+Committee Report: Favorable with amendments
17+Senate action: Adopted
18+Read second time: February 29, 2024
1119
12-FOR the purpose of altering certain reporting requirements on health insurance carriers
13-relating to compliance with the federal Mental Health Parity and Addiction Equity
14-Act; altering requirements for certain analyses of nonquantitative treatment
15-limitations required of health insurance carriers; authorizing the Maryland
16-Insurance Commissioner to exercise discretion to review subsets of nonquantitative
17-treatment limitations under certain circumstances; establishing certain remedies
18-the Commissioner may use to enforce compliance with the Mental Health Parity and
19-Addiction Equity Act and related reporting requirements; establishing that a health
20-insurance carrier has the burden of persuasion in demonstrating that its health plan
21-complies with the federal Mental Health Parity and Addiction Equity Act; repealing
22-the requirement that the Commissioner use a certain form for the reporting
23-requirements; repealing the termination date for the reporting requirements; and
24-generally relating to health insurance carriers and mental health and substance use
25-disorder benefits.
20+CHAPTER ______
2621
27-BY repealing and reenacting, with amendments,
28- Article – Insurance
29-Section 15–144
30- Annotated Code of Maryland
31- (2017 Replacement Volume and 2023 Supplement)
22+AN ACT concerning 1
3223
33-BY repealing and reenacting, without amendments,
34- Article – Insurance
35-Section 15–1309(a)(1) and (3)
36- Annotated Code of Maryland
37- (2017 Replacement Volume and 2023 Supplement)
24+Health Insurance – Mental Health and Substance Use Disorder Benefits – 2
25+Sunset Repeal and Modification of Reporting Requirements 3
3826
39-BY repealing
40- Chapter 211 of the Acts of the General Assembly of 2020
41- Section 2
27+FOR the purpose of altering certain reporting requirements on health insurance carriers 4
28+relating to compliance with the federal Mental Health Parity and Addiction Equity 5
29+Act; altering requirements for certain analyses of nonquantitative treatment 6
30+limitations required of health insurance carriers; authorizing the Maryland 7
31+Insurance Commissioner to exercise discretion to review subsets of nonquantitative 8
32+treatment limitations under certain circumstances; establishing certain remedies 9
33+the Commissioner may use to enforce compliance with the Mental Health Parity and 10
34+Addiction Equity Act and related reporting requirements; establishing that a health 11
35+insurance carrier has the burden of persuasion in demonstrating that its health plan 12
36+complies with the federal Mental Health Parity and Addiction Equity Act; repealing 13
37+the requirement that the Commissioner use a certain form for the reporting 14
38+requirements; repealing the termination date for the reporting requirements; and 15
39+generally relating to health insurance carriers and mental health and substance use 16
40+disorder benefits. 17
4241
43-BY repealing and reenacting, with amendments,
44- Chapter 211 of the Acts of the General Assembly of 2020
45-Section 4
42+BY repealing and reenacting, with amendments, 18
43+ Article – Insurance 19
44+Section 15–144 20
45+ Annotated Code of Maryland 21
46+ (2017 Replacement Volume and 2023 Supplement) 22
4647
47-BY repealing
48- Chapter 212 of the Acts of the General Assembly of 2020
49- Section 2 Ch. 233 2024 LAWS OF MARYLAND
48+BY repealing and reenacting, without amendments, 23 2 SENATE BILL 684
5049
51-– 2 –
5250
53-BY repealing and reenacting, with amendments,
54- Chapter 212 of the Acts of the General Assembly of 2020
55- Section 4
51+ Article – Insurance 1
52+Section 15–1309(a)(1) and (3) 2
53+ Annotated Code of Maryland 3
54+ (2017 Replacement Volume and 2023 Supplement) 4
5655
57- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
58-That the Laws of Maryland read as follows:
56+BY repealing 5
57+ Chapter 211 of the Acts of the General Assembly of 2020 6
58+ Section 2 7
5959
60-Article – Insurance
60+BY repealing and reenacting, with amendments, 8
61+ Chapter 211 of the Acts of the General Assembly of 2020 9
62+Section 4 10
6163
62-15–144.
64+BY repealing 11
65+ Chapter 212 of the Acts of the General Assembly of 2020 12
66+ Section 2 13
6367
64- (a) (1) In this section the following words have the meanings indicated.
68+BY repealing and reenacting, with amendments, 14
69+ Chapter 212 of the Acts of the General Assembly of 2020 15
70+ Section 4 16
6571
66- (2) “Carrier” means:
72+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
73+That the Laws of Maryland read as follows: 18
6774
68- (i) an insurer that holds a certificate of authority in the State and
69-provides health insurance in the State;
75+Article – Insurance 19
7076
71- (ii) a health maintenance organization that is licensed to operate in
72-the State;
77+15–144. 20
7378
74- (iii) a nonprofit health service plan that is licensed to operate in the
75-State; or
79+ (a) (1) In this section the following words have the meanings indicated. 21
7680
77- (iv) any other person or organization that provides health benefit
78-plans subject to State insurance regulation.
81+ (2) “Carrier” means: 22
7982
80- (3) “Health benefit plan” means:
83+ (i) an insurer that holds a certificate of authority in the State and 23
84+provides health insurance in the State; 24
8185
82- (i) for a large group or blanket plan, a health benefit plan as defined
83-in § 15–1401 of this title;
86+ (ii) a health maintenance organization that is licensed to operate in 25
87+the State; 26
8488
85- (ii) for a small group plan, a health benefit plan as defined in §
86-15–1201 of this title;
89+ (iii) a nonprofit health service plan that is licensed to operate in the 27
90+State; or 28
8791
88- (iii) for an individual plan:
92+ (iv) any other person or organization that provides health benefit 29
93+plans subject to State insurance regulation. 30
8994
90- 1. a health benefit plan as defined in § 15–1301(l) of this title;
91-or
95+ (3) “Health benefit plan” means: 31
96+ SENATE BILL 684 3
9297
93- 2. an individual health benefit plan as defined in §
94-15–1301(o) of this title;
9598
96- (iv) short–term limited duration insurance as defined in § 15–1301(s)
97-of this title; or WES MOORE, Governor Ch. 233
99+ (i) for a large group or blanket plan, a health benefit plan as defined 1
100+in § 15–1401 of this title; 2
98101
99-– 3 –
102+ (ii) for a small group plan, a health benefit plan as defined in § 3
103+15–1201 of this title; 4
100104
101- (v) a student health plan as defined in § 15–1318(a) of this title.
105+ (iii) for an individual plan: 5
102106
103- (4) “Medical/surgical benefits” has the meaning stated in 45 C.F.R. §
104-146.136(a) and 29 C.F.R. § 2590.712(a).
107+ 1. a health benefit plan as defined in § 15–1301(l) of this title; 6
108+or 7
105109
106- (5) “Mental health benefits” has the meaning stated in 45 C.F.R. §
107-146.136(a) and 29 C.F.R. § 2590.712(a).
110+ 2. an individual health benefit plan as defined in § 8
111+15–1301(o) of this title; 9
108112
109- (6) “Nonquantitative treatment limitation” means treatment limitations
110-as defined in 45 C.F.R. § 146.136(a) and 29 C.F.R. § 2590.712(a).
113+ (iv) short–term limited duration insurance as defined in § 15–1301(s) 10
114+of this title; or 11
111115
112- (7) (I) “Parity Act” means the Paul Wellstone and Pete Domenici
113-Mental Health Parity and Addiction Equity Act of 2008 [and 45 C.F.R. § 146.136 and 29
114-C.F.R. § 2590.712], AS AMENDED .
116+ (v) a student health plan as defined in § 15–1318(a) of this title. 12
115117
116- (II) “PARITY ACT” INCLUDES 45 C.F.R. § 146.136, 29 C.F.R. §
117-2590.712, AND ANY OTHER RELATE D FEDERAL REGULATION S FOUND IN THE CODE
118-OF FEDERAL REGULATIONS TO IMPLEM ENT OR ENFORCE THE PAUL WELLSTONE
119-AND PETE DOMENICI MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT OF
120-2008.
118+ (4) “Medical/surgical benefits” has the meaning stated in 45 C.F.R. § 13
119+146.136(a) and 29 C.F.R. § 2590.712(a). 14
121120
122- (8) “Parity Act classification” means:
121+ (5) “Mental health benefits” has the meaning stated in 45 C.F.R. § 15
122+146.136(a) and 29 C.F.R. § 2590.712(a). 16
123123
124- (i) inpatient in–network benefits;
124+ (6) “Nonquantitative treatment limitation” means treatment limitations 17
125+as defined in 45 C.F.R. § 146.136(a) and 29 C.F.R. § 2590.712(a). 18
125126
126- (ii) inpatient out–of–network benefits;
127+ (7) (I) “Parity Act” means the Paul Wellstone and Pete Domenici 19
128+Mental Health Parity and Addiction Equity Act of 2008 [and 45 C.F.R. § 146.136 and 29 20
129+C.F.R. § 2590.712], AS AMENDED . 21
127130
128- (iii) outpatient in–network benefits;
131+ (II) “PARITY ACT” INCLUDES 45 C.F.R. § 146.136, 29 C.F.R. § 22
132+2590.712, AND ANY OTHER RELATE D FEDERAL REGULATION S FOUND IN THE CODE 23
133+OF FEDERAL REGULATIONS TO IMPLEM ENT OR ENFORCE THE PAUL WELLSTONE 24
134+AND PETE DOMENICI MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT OF 25
135+2008. 26
129136
130- (iv) outpatient out–of–network benefits;
137+ (8) “Parity Act classification” means: 27
131138
132- (v) prescription drug benefits; and
139+ (i) inpatient in–network benefits; 28
133140
134- (vi) emergency care benefits.
141+ (ii) inpatient out–of–network benefits; 29
135142
136- (9) “PRODUCT” HAS THE MEANING STAT ED IN § 15–1309(A)(3) OF
137-THIS TITLE.
143+ (iii) outpatient in–network benefits; 30
144+ 4 SENATE BILL 684
138145
139- (9) (10) “Substance use disorder benefits” has the meaning stated in 45
140-C.F.R. § 146.136(a) and 29 C.F.R. § 2590.712(a).
141146
142- (b) This section applies to a carrier that delivers or issues for delivery a health
143-benefit plan in the State.
144- Ch. 233 2024 LAWS OF MARYLAND
147+ (iv) outpatient out–of–network benefits; 1
145148
146-– 4 –
147- (C) (1) EACH CARRIER SUBJECT TO THIS SECTION SHAL L:
149+ (v) prescription drug benefits; and 2
148150
149- (I) FOR EACH PARITY ACT CLASSIFICATION , IDENTIFY ALL
150-NONQUANTITATIVE TRE ATMENT LIMITATIONS T HAT ARE APPLIED TO M ENTAL
151-HEALTH BENEFITS , SUBSTANCE USE DISORD ER BENEFITS, AND MEDICAL/SURGICAL
152-BENEFITS;
151+ (vi) emergency care benefits. 3
153152
154- (II) IN ACCORDANCE WITH T HE PARITY ACT, PERFORM AND
155-DOCUMENT COMPARATIVE ANALYSES OF THE DESI GN AND APPLICATION O F ALL
156-NONQUANTITATIVE TREATMENT LIMITATIONS IMPOSED ON MENTAL HEALTH
157-BENEFITS AND SUBSTAN CE USE DISORDER BENE FITS;
153+ (9) “PRODUCT” HAS THE MEANING STAT ED IN § 15–1309(A)(3) OF 4
154+THIS TITLE. 5
158155
159- (III) PROVIDE THE COMPARAT IVE ANALYSIS FOR EAC H
160-NONQUANTITATIVE TREA TMENT LIMITATION REQ UESTED BY THE COMMISSIONER
161-WITHIN:
156+ (9) (10) “Substance use disorder benefits” has the meaning stated in 45 6
157+C.F.R. § 146.136(a) and 29 C.F.R. § 2590.712(a). 7
162158
163- 1. 15 WORKING DAYS A FTER A WRITTEN REQUE ST; OR
159+ (b) This section applies to a carrier that delivers or issues for delivery a health 8
160+benefit plan in the State. 9
164161
165- 2. IF ADOPTED BY THE FE DERAL GOVERNMENT , LESS
166-THAN 15 WORKING DAYS TO ALIG N WITH THE FEDERAL R ULE OR REGULATION ;
162+ (C) (1) EACH CARRIER SUBJECT TO THIS SECTION SHAL L: 10
167163
168- (IV) WITHIN 30 DAYS AFTER A WRITTEN REQUEST, PROVIDE THE
169-COMPARATIVE ANALYSIS FOR EACH NONQUANTITA TIVE TREATMENT LIMITATION
170-AND RELATED IN OPERA TION DATA ANALYSIS , IF AVAILABLE AND REQ UESTED BY A
171-MEMBER IN ACCORDANCE WITH THE PARITY ACT DISCLOSURE REQUIR EMENTS OR,
172-FOR MEMBERS WITH IND IVIDUAL PLANS, IN ACCORDANCE WITH S UBSECTION (E)(7)
173-OF THIS SECTION; AND
164+ (I) FOR EACH PARITY ACT CLASSIFICATION , IDENTIFY ALL 11
165+NONQUANTITATIVE TREA TMENT LIMITATIONS TH AT ARE APPLIED TO ME NTAL 12
166+HEALTH BENEFITS , SUBSTANCE USE DISORD ER BENEFITS, AND MEDICAL/SURGICAL 13
167+BENEFITS; 14
174168
175- (V) SUBMIT THE REPORTS R EQUIRED UNDER PARAGR APH (2)
176-OF THIS SUBSECTION .
169+ (II) IN ACCORDANCE WITH T HE PARITY ACT, PERFORM AND 15
170+DOCUMENT COMPARATIVE ANA LYSES OF THE DESIGN AND APPLICATION OF A LL 16
171+NONQUANTITATIVE TREA TMENT LIMITATIONS IM POSED ON MENTAL HEAL TH 17
172+BENEFITS AND SUBSTAN CE USE DISORDER BENE FITS; 18
177173
178- (c) (1) (2) On or before [March 1, 2022, and March 1, 2024] MARCH 1
179-EACH YEAR, BEGINNING IN 2025 JULY 1, 2024, AND EVERY 2 YEARS THEREAFTER ,
180-each carrier subject to this section shall:
174+ (III) PROVIDE THE COMPARAT IVE ANALYSIS FOR EAC H 19
175+NONQUANTITATIVE TREA TMENT LIMITA TION REQUESTED BY TH E COMMISSIONER 20
176+WITHIN: 21
181177
182- (i) identify the five health benefit plans with the highest enrollment
183-for each product offered by the carrier in the individual, small, and large group markets;
184-and
178+ 1. 15 WORKING DAYS AFTER A WRITTEN REQUEST ; OR 22
185179
186- (ii) submit a report to the Commissioner ON EACH PRODUCT
187-OFFERED BY THE CARRIER IN THE INDIV IDUAL, SMALL, AND LARGE GROUP
188-MARKETS to demonstrate the carrier’s compliance with the Parity Act.
189- WES MOORE, Governor Ch. 233
180+ 2. IF ADOPTED BY THE FE DERAL GOVERNMENT , LESS 23
181+THAN 15 WORKING DAYS TO ALIG N WITH THE FEDERAL R ULE OR REGULATION ; 24
190182
191-– 5 –
192- (2) (3) The report submitted under paragraph (1) (2) of this subsection
193-shall include [the following information]:
183+ (IV) WITHIN 30 DAYS AFTER A WRITTEN REQUEST, PROVIDE THE 25
184+COMPARATIVE ANALYSIS FOR EACH NONQUANTITA TIVE TREATMENT LIMIT ATION 26
185+AND RELATED IN OPERA TION DATA ANALYSIS , IF AVAILABLE AND REQ UESTED BY A 27
186+MEMBER IN ACCORDANCE WITH THE PARITY ACT DISCLOSURE REQUIR EMENTS OR, 28
187+FOR MEMBERS WITH IND IVIDUAL PLANS, IN ACCORDANCE WITH S UBSECTION (E)(7) 29
188+OF THIS SECTION; AND 30
194189
195- (I) ALL NONQUA NTITATIVE TREATMENT LIMITATION
196-COMPARATIVE ANALYSIS INFORMATION REQUIRED UNDER THE PARITY ACT,
197-SUBSECTION (D) OF THIS SECTION , AND ANY STATE REGULATIONS for the health
198-benefit plans identified PRODUCTS IDENTIFIED under [item] PARAGRAPH (1)(i) (2) of
199-this subsection;, INCLUDING:
190+ (V) SUBMIT THE REPORTS R EQUIRED UNDER PARAGR APH (2) 31
191+OF THIS SUBSECTION . 32 SENATE BILL 684 5
200192
201- (i) a description of the process used to develop or select the medical
202-necessity criteria for mental health benefits and substance use disorder benefits and the
203-process used to develop or select the medical necessity criteria for medical and surgical
204-benefits;
205193
206- (ii) for each Parity Act classification, identification of
207-nonquantitative treatment limitations that are applied to mental health benefits and
208-substance use disorder benefits and medical and surgical benefits;
209194
210- (iii) identification of the description of the nonquantitative treatment
211-limitations identified under item (ii) of this paragraph in documents and instruments under
212-which the plan is established or operated; and
195+ (c) (1) (2) On or before [March 1, 2022, and March 1, 2024] MARCH 1 1
196+EACH YEAR, BEGINNING IN 2025 JULY 1, 2024, AND EVERY 2 YEARS THEREAFTER , 2
197+each carrier subject to this section shall: 3
213198
214- (iv) (II) the results of the A comparative analysis as described
215-under subsections (d) and (e) of this section. CONDUCTED BY THE CAR RIER ON NOT
216-FEWER THAN FIVE NONQ UANTITATIVE TREATMEN T LIMITATIONS SELECT ED BY THE
217-COMMISSIONER IN ACCOR DANCE WITH PARAGRAPH (5) OF THIS SUBSECTION ; AND
199+ (i) identify the five health benefit plans with the highest enrollment 4
200+for each product offered by the carrier in the individual, small, and large group markets; 5
201+and 6
218202
219- (III) SUBJECT TO PARAGRAPH (4) OF THIS SUBSECTION , A
220-STATEMENT, SIGNED BY A CORPORAT E OFFICER, ATTESTING THAT , FOR EACH
221-PRODUCT IDENTIFIED U NDER PARAGRAPH (2) OF THIS SUBSECTION , THE SELECTED
222-NONQUANTITATIVE TREA TMENT LIMITATIONS AN D THE PROCESSES , STRATEGIES,
223-EVIDENTIARY STANDARD S, OR OTHER FACTORS USE D IN DESIGNING AND A PPLYING
224-THE SELECTED NONQUAN TITATIVE TREATMENT L IMITATIONS TO MENTAL HEALTH
225-BENEFITS, SUBSTANCE USE DISORD ER BENEFITS , AND MEDICAL /SURGICAL
226-BENEFITS ARE THE SAM E FOR ALL PLANS WITH IN THE PRODUCT, AS WRITTEN AND
227-IN OPERATION.
203+ (ii) submit a report to the Commissioner ON EACH PRODUCT 7
204+OFFERED BY THE CARRI ER IN THE INDIVIDUAL , SMALL, AND LARGE GROUP 8
205+MARKETS to demonstrate the carrier’s compliance with the Parity Act. 9
228206
229- (4) IF, FOR ANY PLAN WITHIN A PRODUCT IDENTIFIED UNDER
230-PARAGRAPH (2) OF THIS SUBSECTION , THE PROCESSES , STRATEGIES, EVIDENTIARY
231-STANDARDS, OR OTHER FACTORS USE D IN DESIGNING AND A PPLYING THE
232-SELECTED NONQUANTITA TIVE TREATMENT LIMITATI ONS TO MENTAL HEALTH
233-BENEFITS, SUBSTANCE USE DISORD ER BENEFITS, OR MEDICAL/SURGICAL BENEFITS
234-ARE DIFFERENT , AS WRITTEN OR IN OPE RATION, FROM THE OTHER PLANS WITHIN
235-THE PRODUCT : Ch. 233 2024 LAWS OF MARYLAND
207+ (2) (3) The report submitted under paragraph (1) (2) of this subsection 10
208+shall include [the following information]: 11
236209
237-– 6 –
210+ (I) ALL NONQUANTITATIVE TREATMENT LIMITATION 12
211+COMPARATIVE ANALYSIS INFORMATION REQUIRED UNDER THE PARITY ACT, 13
212+SUBSECTION (D) OF THIS SECTION , AND ANY STATE REGULATIONS for the health 14
213+benefit plans identified PRODUCTS IDENTIFIED under [item] PARAGRAPH (1)(i) (2) of 15
214+this subsection;, INCLUDING: 16
238215
239- (I) THE STATEMENT REQUIR ED UNDER PARAGRAPH (3)(III) OF
240-THIS SUBSECTION SHAL L NOTE THE EXCEPTION AND IDENTIFY THE PLA N; AND
216+ (i) a description of the process used to develop or select the medical 17
217+necessity criteria for mental health benefits and substance use disorder benefits and the 18
218+process used to develop or select the medical necessity criteria for medical and surgical 19
219+benefits; 20
241220
242- (II) THE CARRIER SHALL SU BMIT A SEPARATE COMP ARATIVE
243-ANALYSIS FOR THE SEL ECTED NONQUANTITATIV E TREATMENT LIMITATI ONS FOR
244-THE PLAN.
221+ (ii) for each Parity Act classification, identification of 21
222+nonquantitative treatment limitations that are applied to mental health benefits and 22
223+substance use disorder benefits and medical and surgical benefits; 23
245224
246- (5) (I) IN SELECTING THE NONQ UANTITATIVE TREATMEN T
247-LIMITATIONS REQUIRED TO BE INCLUDED FOR E ACH REPORTING PERIOD , THE
248-COMMISSIONER :
225+ (iii) identification of the description of the nonquantitative treatment 24
226+limitations identified under item (ii) of this paragraph in documents and instruments under 25
227+which the plan is established or operated; and 26
249228
250- 1. SHALL PRIORITIZE THE NONQUANTITATIVE
251-TREATMENT LIMITATION S IDENTIFIED BY THE COMMISSIONER AS HAVIN G THE
252-GREATEST IMPACT ON M EMBER ACCESS TO CARE ;
229+ (iv) (II) the results of the A comparative analysis as described 27
230+under subsections (d) and (e) of this section. CONDUCTED BY THE CAR RIER ON NOT 28
231+FEWER THAN FIVE NONQ UANTITATIVE TREATMEN T LIMITATIONS SELECTED BY THE 29
232+COMMISSIONER IN ACCOR DANCE WITH PARAGRAPH (5) OF THIS SUBSECTION ; AND 30
253233
254- 2. SHALL REVIE W THE SAME SUBSET OF
255-NONQUANTITATIVE TREA TMENT LIMITATIONS FO R EACH CARRIER REPOR T; AND
234+ (III) SUBJECT TO PARAGRAPH (4) OF THIS SUBSECTION , A 31
235+STATEMENT, SIGNED BY A CORPORAT E OFFICER, ATTESTING THAT , FOR EACH 32
236+PRODUCT IDENTIFIED U NDER PARAGRAPH (2) OF THIS SUBSECTION, THE SELECTED 33
237+NONQUANTITATIVE TREA TMENT LIMITATIONS AN D THE PROCESSES , STRATEGIES, 34
238+EVIDENTIARY STANDARD S, OR OTHER FACTORS USE D IN DESIGNING AND A PPLYING 35 6 SENATE BILL 684
256239
257- 3. MAY TAKE INTO CONSID ERATION OTHER FACTOR S
258-DETERMINED RELEVANT BY THE COMMISSIONER , INCLUDING COMPLAINT TRENDS,
259-FEDERAL PARITY ACT GUIDANCE , AND WHETHER THE NON QUANTITATIVE
260-TREATMENT LIMITATION WAS SELECTED FOR A P REVIOUS REPORTING YE AR.
261240
262- (II) OF THE FIVE SELECTED NONQUANTITATIVE TREA TMENT
263-LIMITATIONS:
241+THE SELECTED NONQUAN TITATIVE TREATMENT L IMITATIONS TO MENTAL HEALTH 1
242+BENEFITS, SUBSTANCE U SE DISORDER BENEFITS , AND MEDICAL /SURGICAL 2
243+BENEFITS ARE THE SAM E FOR ALL PLANS WITH IN THE PRODUCT , AS WRITTEN AND 3
244+IN OPERATION. 4
264245
265- 1. NOT MORE THAN TWO MA Y BE FOR UTILIZATION
266-REVIEW; AND
246+ (4) IF, FOR ANY PLAN WITHIN A PRODUCT IDENTIFIED UNDER 5
247+PARAGRAPH (2) OF THIS SUBSECTION , THE PROCESSES , STRATEGIES, EVIDENTIARY 6
248+STANDARDS, OR OTHER FACTORS USE D IN DESIGNING AND A PPLYING THE 7
249+SELECTED NONQUANTITA TIVE TREATMENT LIMIT ATIONS TO MENTAL HEA LTH 8
250+BENEFITS, SUBSTANCE USE DISORD ER BENEFITS, OR MEDICAL/SURGICAL BENEFITS 9
251+ARE DIFFERENT , AS WRITTEN OR IN OPE RATION, FROM THE OT HER PLANS WITHIN 10
252+THE PRODUCT : 11
267253
268- 2. AT LEAST ONE MUST BE FOR NETWORK COMPOSITION ,
269-INCLUDING REIMBURSEM ENT RATE SETTING .
254+ (I) THE STATEMENT REQUIR ED UNDER PARAGRAPH (3)(III) OF 12
255+THIS SUBSECTION SHAL L NOTE THE EXCEPTION AND IDENTIFY THE PLA N; AND 13
270256
271- (6) A FINDING OF NONCOMPLI ANCE FOR A PRODUCT S HALL APPLY TO
272-ALL PLANS WITHIN THE PRODUCT.
257+ (II) THE CARRIER SHALL SU BMIT A SEPARATE COMP ARATIVE 14
258+ANALYSIS FOR THE SEL ECTED NONQUANTITATIV E TREATMENT LIMITATION S FOR 15
259+THE PLAN. 16
273260
274- (d) (1) A carrier subject to this section shall conduct a comparative analysis
275-for the nonquantitative treatment limitations identified SELECTED under subsection
276-(c)(2)(ii) (C)(5) of this section as nonquantitative treatment limitations are:
261+ (5) (I) IN SELECTING THE NONQ UANTITATIVE TREATMEN T 17
262+LIMITATIONS REQUIRED TO BE INCLUDED FOR E ACH REPORTING PERIOD , THE 18
263+COMMISSIONER : 19
277264
278- (i) written; and
265+ 1. SHALL PRIORITIZE THE NONQUANTITATIVE 20
266+TREATMENT LIMITATION S IDENTIFIED BY THE COMMISSIONER AS HAVIN G THE 21
267+GREATEST IMPACT ON M EMBER ACCESS TO CARE ; 22
279268
280- (ii) in operation.
281- WES MOORE, Governor Ch. 233
269+ 2. SHALL REVIEW THE SAM E SUBSET OF 23
270+NONQUANTITATIVE TREA TMENT LIMITATIONS FO R EACH CARRIER REPOR T; AND 24
282271
283-– 7 –
284- (2) The comparative analysis of the nonquantitative treatment limitations
285-identified SELECTED under subsection (c)(2)(ii) (C)(5) of this section shall:
272+ 3. MAY TAKE INTO CONSID ERATION OTHER FACTOR S 25
273+DETERMINED RELEVANT BY THE COMMISSIONER , INCLUDING COMPLAINT TRENDS, 26
274+FEDERAL PARITY ACT GUIDANCE , AND WHETHER THE NONQ UANTITATIVE 27
275+TREATMENT LIMITATION WAS SELECTED FOR A P REVIOUS REPORTING YE AR. 28
286276
287- (I) demonstrate that the processes, strategies, evidentiary
288-standards, or other factors used in DESIGNING AND applying the medical necessity criteria
289-and each SELECTED nonquantitative treatment limitation to mental health benefits and
290-substance use disorder benefits in each Parity Act classification are comparable to, and are
291-applied no more stringently than, the processes, strategies, evidentiary standards, or other
292-factors used in DESIGNING AND applying the medical necessity criteria and each
293-SELECTED nonquantitative treatment limitation to medical and surgical
294-MEDICAL/SURGICAL benefits within the same Parity Act classification; AND
277+ (II) OF THE FIVE SELECTED NONQUANTITATIVE TREA TMENT 29
278+LIMITATIONS: 30
295279
296- (II) INCLUDE ALL INFORMAT ION REQUIRED UNDER THE PARITY
297-ACT.
280+ 1. NOT MORE THAN TWO MAY BE FOR UTILIZATION 31
281+REVIEW; AND 32
298282
299- (3) REGARDLESS OF WHETHER IT WAS USED BEFORE T HE PARITY
300-ACT WAS ENACTED AND A S REQUESTED BY THE COMMISSION, A CARRIER SHALL
301-PERFORM AND PROVIDE A COMPARATIVE ANALYS IS FOR EACH PROCESS , STRATEGY,
302-EVIDENTIARY STANDARD , OR OTHER FACTOR USED IN DESIG NING AND APPLYING A
303-SELECTED NONQUANTITA TIVE TREATMENT LIMIT ATION USED DURING A
304-REPORTING PERIOD .
283+ 2. AT LEAST ONE MUST BE FOR NETWORK COMPOSIT ION, 33
284+INCLUDING REIMBURSEM ENT RATE SETTING . 34 SENATE BILL 684 7
305285
306- (e) In providing the analysis required under subsection (d) of this section, a
307-carrier shall:
308286
309- (1) identify the factors used to determine that a nonquantitative treatment
310-limitation will apply to a benefit, including:
311287
312- (i) the sources for the factors, INCLUDING SOURCES IN EFFECT
313-BEFORE THE ENACTMENT OF THE PARITY ACT;
288+ (6) A FINDING OF NONCOMPLI ANCE FOR A PRODUCT S HALL APPLY TO 1
289+ALL PLANS WITHIN THE PRODUCT. 2
314290
315- (ii) the factors that were considered but rejected; [and]
291+ (d) (1) A carrier subject to this section shall conduct a comparative analysis 3
292+for the nonquantitative treatment limitations identified SELECTED under subsection 4
293+(c)(2)(ii) (C)(5) of this section as nonquantitative treatment limitations are: 5
316294
317- (III) THE FACTORS THAT WER E IN EFFECT BEFORE T HE
318-ENACTMENT OF THE PARITY ACT AND ARE USED IN T HE DESIGN OR APPLICA TION
319-OF THE NONQUANTITATI VE TREATMENT LIMITAT ION; AND
295+ (i) written; and 6
320296
321- [(iii)] (IV) if a factor was given more weight than another, the reason
322-for the difference in weighting;
297+ (ii) in operation. 7
323298
324- (2) identify and define the specific evidentiary standards used to define the
325-factors and any other evidence relied on in designing each nonquantitative treatment
326-limitation, INCLUDING EVIDENTIAR Y STANDARDS IN EFFEC T BEFORE THE
327-ENACTMENT OF THE PARITY ACT; Ch. 233 2024 LAWS OF MARYLAND
299+ (2) The comparative analysis of the nonquantitative treatment limitations 8
300+identified SELECTED under subsection (c)(2)(ii) (C)(5) of this section shall: 9
328301
329-– 8 –
302+ (I) demonstrate that the processes, strategies, evidentiary 10
303+standards, or other factors used in DESIGNING AND applying the medical necessity criteria 11
304+and each SELECTED nonquantitative treatment limitation to mental health benefits and 12
305+substance use disorder benefits in each Parity Act classification are comparable to, and are 13
306+applied no more stringently than, the processes, strategies, evidentiary standards, or other 14
307+factors used in DESIGNING AND applying the medical necessity criteria and each 15
308+SELECTED nonquantitative treatment limitation to medical and surgical 16
309+MEDICAL/SURGICAL benefits within the same Parity Act classification; AND 17
330310
331- (3) IDENTIFY AND DEFINE THE PROCESSES AND ST RATEGIES THAT
332-ARE USED TO DESIGN O R APPLY THE NONQUANT ITATIVE TREATMENT LI MITATION,
333-INCLUDING THE PROCES SES AND STRATEGIES I N EFFECT BEFORE THE ENACTMENT
334-OF THE PARITY ACT;
311+ (II) INCLUDE ALL INFORMAT ION REQUIRED UNDER THE PARITY 18
312+ACT. 19
335313
336- [(3)] (4) include the results of the audits, reviews, and analyses
337-performed on the nonquantitative treatment limitations identified under subsection
338-(c)(2)(ii) (C)(5) of this section to conduct the analysis required under subsection (d)(2) of
339-this section for the plans AND PRODUCTS as written;
314+ (3) REGARDLESS OF WHETHER IT WAS USED BEFORE T HE PARITY 20
315+ACT WAS ENACTED AND A S REQUESTED BY THE COMMISSION, A CARRIER SHALL 21
316+PERFORM AND PROVIDE A COMPARATIVE ANALYS IS FOR EACH PROCESS , STRATEGY, 22
317+EVIDENTIARY STANDARD , OR OTHER FACTOR USED IN DESIG NING AND APPLYING A 23
318+SELECTED NONQUANTITA TIVE TREATMENT LIMIT ATION USED DURING A 24
319+REPORTING PERIOD . 25
340320
341- [(4)] (5) include the results of the audits, reviews, and analyses
342-performed on the nonquantitative treatment limitations identified under subsection
343-(c)(2)(ii) (C)(5) of this section to conduct the analysis required under subsection (d)(2) of
344-this section for the plans AND PRODUCTS as in operation;
321+ (e) In providing the analysis required under subsection (d) of this section, a 26
322+carrier shall: 27
345323
346- [(5)] (6) identify the measures used to ensure comparable design and
347-application of nonquantitative treatment limitations that are implemented by the carrier
348-and any entity delegated by the carrier to manage mental health benefits, substance use
349-disorder benefits, or medical/surgical benefits on behalf of the carrier;
324+ (1) identify the factors used to determine that a nonquantitative treatment 28
325+limitation will apply to a benefit, including: 29
350326
351- [(6)] (7) disclose the specific findings and conclusions reached by the
352-carrier that indicate that the health benefit plan is in compliance with this section and the
353-Parity Act [and its implementing regulations, including 45 C.F.R. 146.136 and 29 C.F.R.
354-2590.712 and any other related federal regulations found in the Code of Federal
355-Regulations]; and
327+ (i) the sources for the factors, INCLUDING SOURCES IN EFFECT 30
328+BEFORE THE ENACTMENT OF THE PARITY ACT; 31
356329
357- [(7)] (8) identify the process used to comply with the Parity Act disclosure
358-requirements for mental health benefits, substance use disorder benefits, and
359-medical/surgical benefits, including:
330+ (ii) the factors that were considered but rejected; [and] 32
331+ 8 SENATE BILL 684
360332
361- (i) the criteria for a medical necessity determination;
362333
363- (ii) reasons for a denial of benefits; and
334+ (III) THE FACTORS THAT WER E IN EFFECT BEFORE T HE 1
335+ENACTMENT OF THE PARITY ACT AND ARE USED IN T HE DESIGN OR APPLICA TION 2
336+OF THE NONQUANTITATI VE TREATMENT LIMITAT ION; AND 3
364337
365- (iii) in connection with a member’s request for INDIVIDUAL OR group
366-plan information and for purposes of filing an internal coverage or grievance matter and
367-appeals, plan documents that contain information about processes, strategies, evidentiary
368-standards, and any other factors used to apply a nonquantitative treatment limitation.
338+ [(iii)] (IV) if a factor was given more weight than another, the reason 4
339+for the difference in weighting; 5
369340
370- (f) On or before [March 1, 2022, and March 1, 2024] MARCH 1 EACH YEAR,
371-BEGINNING IN 2025, each carrier subject to this section shall submit a report for the
372-health benefit plans identified under subsection (c)(1)(i) of this section to the Commissioner
373-on the following data for the immediately preceding calendar year for mental health WES MOORE, Governor Ch. 233
341+ (2) identify and define the specific evidentiary standards used to define the 6
342+factors and any other evidence relied on in designing each nonquantitative treatment 7
343+limitation, INCLUDING EVIDENTIAR Y STANDARDS IN EFFEC T BEFORE THE 8
344+ENACTMENT OF THE PARITY ACT; 9
374345
375-– 9 –
376-benefits, substance use disorder benefits, and medical/surgical benefits by Parity Act
377-classification:
346+ (3) IDENTIFY AND DEFINE THE PROCESSES AND ST RATEGIES THAT 10
347+ARE USED TO DESIGN O R APPLY THE NONQUANT ITATIVE TREATMENT LI MITATION, 11
348+INCLUDING THE PROCES SES AND STRATEGIES I N EFFECT BEFORE THE ENACTMENT 12
349+OF THE PARITY ACT; 13
378350
379- (1) the frequency, reported by number and rate, with which the health
380-benefit plan received, approved, and denied prior authorization requests for mental health
381-benefits, substance use disorder benefits, and medical and surgical benefits in each Parity
382-Act classification during the immediately preceding calendar year; [and]
351+ [(3)] (4) include the results of the audits, reviews, and analyses 14
352+performed on the nonquantitative treatment limitations identified under subsection 15
353+(c)(2)(ii) (C)(5) of this section to conduct the analysis required under subsection (d)(2) of 16
354+this section for the plans AND PRODUCTS as written; 17
383355
384- (2) the number of claims submitted for mental health benefits, substance
385-use disorder benefits, and medical and surgical benefits in each Parity Act classification
386-during the immediately preceding calendar year and the number and rates of, and reasons
387-for, denial of claims; AND
356+ [(4)] (5) include the results of the audits, reviews, and analyses 18
357+performed on the nonquantitative treatment limitations identified under subsection 19
358+(c)(2)(ii) (C)(5) of this section to conduct the analysis required under subsection (d)(2) of 20
359+this section for the plans AND PRODUCTS as in operation; 21
388360
389- (3) DATA IDENTIFIED BY T HE COMMISSIONER OR FEDER AL
390-REGULATIONS TO EVALU ATE NONQUANTITATIVE TREATMENT LIMITATION
391-COMPLIANCE WITH THE IN–OPERATION STANDARD O F THE PARITY ACT.
361+ [(5)] (6) identify the measures used to ensure comparable design and 22
362+application of nonquantitative treatment limitations that are implemented by the carrier 23
363+and any entity delegated by the carrier to manage mental health benefits, substance use 24
364+disorder benefits, or medical/surgical benefits on behalf of the carrier; 25
392365
393- (F) THE COMMISSIONER SHALL :
366+ [(6)] (7) disclose the specific findings and conclusions reached by the 26
367+carrier that indicate that the health benefit plan is in compliance with this section and the 27
368+Parity Act [and its implementing regulations, including 45 C.F.R. 146.136 and 29 C.F.R. 28
369+2590.712 and any other related federal regulations found in the Code of Federal 29
370+Regulations]; and 30
394371
395- (1) DEVELOP ADDITIONAL S TANDARDIZED DATA TEM PLATES:
372+ [(7)] (8) identify the process used to comply with the Parity Act disclosure 31
373+requirements for mental health benefits, substance use disorder benefits, and 32
374+medical/surgical benefits, including: 33
396375
397- (I) TO EVALUATE THE COMP ARATIVE ANALYSIS OF
398-NONQUANTITATIVE TREA TMENT LIMITATIONS IN OPERATION; AND
376+ (i) the criteria for a medical necessity determination; 34
399377
400- (II) THAT MEET OR EXCEED ANY MINIMUM REQUIREM ENTS FOR
401-DATA REPORTING SPECI FIED IN FEDERAL REGU LATIONS;
378+ (ii) reasons for a denial of benefits; and 35 SENATE BILL 684 9
402379
403- (2) REQUIRE EACH CARRIER SUBJECT TO THIS SECT ION TO SUBMIT:
404380
405- (I) FOR EACH PRODUCT IDE NTIFIED UNDER SUBSEC TION
406-(C)(2) OF THIS SECTION , THE DATA TEMPLATES D ESCRIBED IN ITEM (1) OF THIS
407-SUBSECTION FOR THE N ONQUANTITATIVE TREAT MENT LIMITATIONS SE LECTED BY
408-THE COMMISSIONER FOR THE REPORTING YEAR IN AC CORDANCE WITH SUBSEC TION
409-(C)(5) OF THIS SECTION; AND
410381
411- (II) A SEPARATE DATA TEMP LATE FOR ANY PLANS D ESCRIBED
412-IN SUBSECTION (C)(4) OF THIS SECTION; AND
382+ (iii) in connection with a member’s request for INDIVIDUAL OR group 1
383+plan information and for purposes of filing an internal coverage or grievance matter and 2
384+appeals, plan documents that contain information about processes, strategies, evidentiary 3
385+standards, and any other factors used to apply a nonquantitative treatment limitation. 4
413386
414- (3) POST THE DATA TEMPLA TES ON THE ADMINISTRATION ’S WEBSITE
415-FOR A COMMENT PERIOD OF NOT LESS THAN 30 DAYS BEFORE ADOPTION .
387+ (f) On or before [March 1, 2022, and March 1, 2024] MARCH 1 EACH YEAR, 5
388+BEGINNING IN 2025, each carrier subject to this section shall submit a report for the 6
389+health benefit plans identified under subsection (c)(1)(i) of this section to the Commissioner 7
390+on the following data for the immediately preceding calendar year for mental health 8
391+benefits, substance use disorder benefits, and medical/surgical benefits by Parity Act 9
392+classification: 10
416393
417- (g) The reports required under subsections (c) and (f) of this section shall:
394+ (1) the frequency, reported by number and rate, with which the health 11
395+benefit plan received, approved, and denied prior authorization requests for mental health 12
396+benefits, substance use disorder benefits, and medical and surgical benefits in each Parity 13
397+Act classification during the immediately preceding calendar year; [and] 14
418398
419- (1) be submitted on a standard form developed by the Commissioner THAT
420-CONFORMS TO MEETS OR EXCEEDS ANY MINIMUM REQUIREMENTS SPECIFIED IN Ch. 233 2024 LAWS OF MARYLAND
399+ (2) the number of claims submitted for mental health benefits, substance 15
400+use disorder benefits, and medical and surgical benefits in each Parity Act classification 16
401+during the immediately preceding calendar year and the number and rates of, and reasons 17
402+for, denial of claims; AND 18
421403
422-– 10 –
423-THE FEDERAL REGULATI ONS AND SUB –REGULATORY GUIDANCE ON
424-NONQUANTITATIVE TREA TMENT LIMITATIONS COMPARATIVE ANALYSIS
425-REPORTING ;
404+ (3) DATA IDENTIFIED BY T HE COMMISSIONER OR FEDER AL 19
405+REGULATIONS TO EVALU ATE NONQUANTITATIVE TREATMENT LIMITATION 20
406+COMPLIANCE WITH THE IN–OPERATION STANDARD O F THE PARITY ACT. 21
426407
427- (2) be submitted by the carrier that issues or delivers the health benefit
428-plan PRODUCT;
408+ (F) THE COMMISSIONER SHALL : 22
429409
430- (3) be prepared in coordination with any entity the carrier contracts with
431-to provide mental health benefits and substance use disorder benefits;
410+ (1) DEVELOP ADDITIONAL S TANDARDIZED DATA TEM PLATES: 23
432411
433- (4) contain a statement, signed by a corporate officer, attesting to the
434-accuracy of the information contained in the report;
412+ (I) TO EVALUATE THE COMP ARATIVE ANALYSIS OF 24
413+NONQUANTITATIVE TREA TMENT LIMITATIONS IN OPERATION; AND 25
435414
436- (5) be available to plan members and the public on the carrier’s website in
437-a summary form that removes confidential or proprietary information and is developed by
438-the Commissioner in accordance with subsection [(m)(2)] (N)(2) of this section; and
415+ (II) THAT MEET OR EXCEED ANY MINIMUM REQUIREM ENTS FOR 26
416+DATA REPORTING SPECI FIED IN FEDERAL REGU LATIONS; 27
439417
440- (6) exclude any identifying information of any plan member.
418+ (2) REQUIRE EACH CARRIER SUBJECT TO THIS SECT ION TO SUBMIT: 28
441419
442- (h) (1) A carrier submitting a report under subsections (c) and (f) of this section
443-may submit a written request to the Commissioner that disclosure of specific information
444-included in the report be denied under the Public Information Act and, if submitting a
445-request, shall:
420+ (I) FOR EACH PRODUCT IDE NTIFIED UNDER SUBSEC TION 29
421+(C)(2) OF THIS SECTION , THE DATA TEMPLATE S DESCRIBED IN ITEM (1) OF THIS 30
422+SUBSECTION FOR THE N ONQUANTITATIVE TREAT MENT LIMITATIONS SEL ECTED BY 31
423+THE COMMISSIONER FOR THE REPORTING YEAR IN AC CORDANCE WITH SUBSEC TION 32
424+(C)(5) OF THIS SECTION; AND 33
425+ 10 SENATE BILL 684
446426
447- (i) identify the particular information the disclosure of which the
448-carrier requests be denied; and
449427
450- (ii) cite the statutory authority under the Public Information Act
451-that authorizes denial of access to the information.
428+ (II) A SEPARATE DATA TEMP LATE FOR ANY PLANS D ESCRIBED 1
429+IN SUBSECTION (C)(4) OF THIS SECTION; AND 2
452430
453- (2) The Commissioner may review a request submitted under paragraph
454-(1) of this subsection on receipt of a request for access to the information under the Public
455-Information Act.
431+ (3) POST THE DATA TEMPLA TES ON THE ADMINISTRATION ’S WEBSITE 3
432+FOR A COMMENT PERIOD OF NOT LESS THAN 30 DAYS BEFORE ADOPTION . 4
456433
457- (3) The Commissioner may notify the carrier that submitted the request
458-under paragraph (1) of this subsection before granting access to information that was the
459-subject of the request.
434+ (g) The reports required under subsections (c) and (f) of this section shall: 5
460435
461- (4) A carrier shall disclose to a member on request any plan information
462-contained in a report that is required to be disclosed to that member under federal or State
463-law.
436+ (1) be submitted on a standard form developed by the Commissioner THAT 6
437+CONFORMS TO MEETS OR EXCEEDS ANY MINIMUM REQUIREMENTS SPECIFIED IN 7
438+THE FEDERAL REGULATI ONS AND SUB –REGULATORY GUIDANCE ON 8
439+NONQUANTITATIVE TREA TMENT LIMITATIONS COMPARATIVE ANALYSIS 9
440+REPORTING; 10
464441
465- (i) (1) The Commissioner shall:
466- WES MOORE, Governor Ch. 233
442+ (2) be submitted by the carrier that issues or delivers the health benefit 11
443+plan PRODUCT; 12
467444
468-– 11 –
469- [(1)] (I) review each report submitted in accordance with subsections (c),
470-(D), and (f) of this section to assess each carrier’s compliance with the Parity Act FOR EACH
471-PARITY ACT CLASSIFICATION ;
445+ (3) be prepared in coordination with any entity the carrier contracts with 13
446+to provide mental health benefits and substance use disorder benefits; 14
472447
473- [(2)] (II) notify a carrier in writing of any noncompliance with the Parity
474-Act before issuing an administrative order; and
448+ (4) contain a statement, signed by a corporate officer, attesting to the 15
449+accuracy of the information contained in the report; 16
475450
476- [(3)] (III) within 90 days after the notice of noncompliance is issued, allow
477-the carrier to:
451+ (5) be available to plan members and the public on the carrier’s website in 17
452+a summary form that removes confidential or proprietary information and is developed by 18
453+the Commissioner in accordance with subsection [(m)(2)] (N)(2) of this section; and 19
478454
479- [(i)] 1. submit a compliance plan to the Administration to comply
480-with the Parity Act; and
455+ (6) exclude any identifying information of any plan member. 20
481456
482- [(ii)] 2. reprocess any claims that were improperly denied, in
483-whole or in part, because of the noncompliance.
457+ (h) (1) A carrier submitting a report under subsections (c) and (f) of this section 21
458+may submit a written request to the Commissioner that disclosure of specific information 22
459+included in the report be denied under the Public Information Act and, if submitting a 23
460+request, shall: 24
484461
485- (2) THE COMMISSIONER MAY EXER CISE DISCRETION TO R EVIEW A
486-SUBSET OF NONQUANTIT ATIVE TREATMENT LIMI TATIONS FOR THE PURP OSES OF
487-THIS SECTION IF THE COMMISSIONER :
462+ (i) identify the particular information the disclosure of which the 25
463+carrier requests be denied; and 26
488464
489- (I) AFTER THE REPORTING DEADLINES ESTABLISHE D UNDER
490-SUBSECTIONS (C) AND (F) OF THIS SECTION , IDENTIFIES THE NONQU ANTITATIVE
491-TREATMENT LIMITATION S THAT WILL BE REVIE WED BY THE COMMISSIONER ;
465+ (ii) cite the statutory authority under the Public Information Act 27
466+that authorizes denial of access to the information. 28
492467
493- (II) DESCRIBES AND POSTS ON THE ADMINISTRATION ’S
494-WEBSITE THE CRITERIA USED TO IDENTIFY THE NONQUANTITATIVE TREA TMENT
495-LIMITATIONS THAT WILL BE REVI EWED EACH YEAR ;
468+ (2) The Commissioner may review a request submitted under paragraph 29
469+(1) of this subsection on receipt of a request for access to the information under the Public 30
470+Information Act. 31
471+ SENATE BILL 684 11
496472
497- (III) REVIEWS NONQUANTITAT IVE TREATMENT LIMITA TIONS
498-THAT HAVE THE GREATE ST EFFECT ON ACCESS TO MENTAL HEALTH AND
499-SUBSTANCE USE DISORD ER CARE;
500473
501- (IV) REVIEWS THE SAME SUB SET OF NONQUANTITATI VE
502-TREATMENT LIMITATION S FOR EACH CARRIER REP ORT;
474+ (3) The Commissioner may notify the carrier that submitted the request 1
475+under paragraph (1) of this subsection before granting access to information that was the 2
476+subject of the request. 3
503477
504- (V) REVIEWS NOT LESS THA N 10 NONQUANTITATIVE
505-TREATMENT LIMITATION S FOR EACH CARRIER R EPORT; AND
478+ (4) A carrier shall disclose to a member on request any plan information 4
479+contained in a report that is required to be disclosed to that member under federal or State 5
480+law. 6
506481
507- (VI) ISSUES A DETERMINATI ON IN ANY MATTER THA T
508-IMPLICATES PARITY ACT COMPLIANCE REGARD LESS OF WHETHER A
509-NONQUANTITATIVE TREATMENT LIMITATION AT ISSUE IN THE MATT ER HAS BEEN
510-REVIEWED UNDER THIS SECTION.
511- Ch. 233 2024 LAWS OF MARYLAND
482+ (i) (1) The Commissioner shall: 7
512483
513-– 12 –
514- (2) THE COMMISSIONER MAY REQU IRE CARRIERS TO COMP LETE
515-DATA TEMPLATES FOR A NONQUANTITATIVE TREA TMENT LIMITATION MOR E
516-FREQUENTLY THAN EVER Y 2 YEARS.
484+ [(1)] (I) review each report submitted in accordance with subsections (c), 8
485+(D), and (f) of this section to assess each carrier’s compliance with the Parity Act FOR EACH 9
486+PARITY ACT CLASSIFICATION ; 10
517487
518- (j) (1) If the Commissioner finds that the carrier failed to submit a complete
519-report required under subsection (c) or (f) of this section, the Commissioner may:
488+ [(2)] (II) notify a carrier in writing of any noncompliance with the Parity 11
489+Act before issuing an administrative order; and 12
520490
521- (I) TAKE ACTION AUTHORIZ ED UNDER PARAGRAPH (2) OF THIS
522-SUBSECTION;
491+ [(3)] (III) within 90 days after the notice of noncompliance is issued, allow 13
492+the carrier to: 14
523493
524- (II) IN ACCORDANCE WITH § 2–208 OF THIS ARTICLE , CHARGE
525-THE CARRIER FOR ANY ADDITIONAL EXPENSES INCURRED BY THE COMMISSIONER
526-TO REVIEW ADDITIONAL REPORTS;
494+ [(i)] 1. submit a compliance plan to the Administration to comply 15
495+with the Parity Act; and 16
527496
528- (III) IMPOSE A PENALTY FOR EACH DAY THAT THE CA RRIER
529-FAILS TO SUBMIT INFO RMATION REQUIRED BY THE COMMISSIONER TO EVALU ATE
530-COMPLIANCE; OR
497+ [(ii)] 2. reprocess any claims that were improperly denied, in 17
498+whole or in part, because of the noncompliance. 18
531499
532- (IV) impose any penalty or take any action as authorized:
500+ (2) THE COMMISSIONER MAY EXER CISE DISCRETION TO R EVIEW A 19
501+SUBSET OF NONQUANTIT ATIVE TREATMENT LIMI TATIONS FOR THE PURP OSES OF 20
502+THIS SECTION IF THE COMMISSIONER : 21
533503
534- (1) 1. for an insurer, nonprofit health service plan, or any other
535-person subject to this section, under this article; or
504+ (I) AFTER THE REPORTING DEADLINES ESTABLISHE D UNDER 22
505+SUBSECTIONS (C) AND (F) OF THIS SECTION , IDENTIFIES THE NONQU ANTITATIVE 23
506+TREATMENT LIMITATION S THAT WILL BE REVIE WED BY THE COMMISSIONER ; 24
536507
537- (2) 2. for a health maintenance organization, under this article
538-or the Health – General Article.
508+ (II) DESCRIBES AND POSTS ON THE ADMINISTRATION’S 25
509+WEBSITE THE CRITERIA USED TO IDENTIFY THE NONQUANTITATIVE TREA TMENT 26
510+LIMITATIONS THAT WIL L BE REVIEWED EACH Y EAR; 27
539511
540- (2) IF THE COMMISSIONER CANNOT M AKE A DETERMINATION THAT A
541-SPECIFIC CONDUCT OR PRACTICE IS COMPLIAN T WITH THE PARITY ACT BECAUSE
542-THE CARRIER FAILED T O PROVIDE A SUFFICIE NT COMPARATIVE ANALY SIS FOR A
543-NONQUAN TITATIVE TREATMENT L IMITATION, THE COMMISSIONER MAY :
512+ (III) REVIEWS NONQUANTITAT IVE TREATMENT LIMITA TIONS 28
513+THAT HAVE THE GREATE ST EFFECT ON ACCESS TO MENTAL HEALTH AND 29
514+SUBSTANCE USE DISO RDER CARE; 30
544515
545- (I) ISSUE AN ADMINISTRAT IVE ORDER REQUIRING THE
546-CARRIER OR AN ENTITY DELEGATED BY THE CAR RIER TO TAKE THE FOL LOWING
547-ACTION UNTIL THE COMMISSIONER CAN MAKE A DETERMINATION OF C OMPLIANCE
548-WITH THE PARITY ACT:
516+ (IV) REVIEWS THE SAME SUB SET OF NONQUANTITATI VE 31
517+TREATMENT LIMITATION S FOR EACH CARRIER R EPORT; 32
518+ 12 SENATE BILL 684
549519
550- 1. MODIFY THE CONDUCT O R PRACTICE AS SPECIF IED
551-BY THE COMMISSIONER ;
552520
553- 2. CEASE THE CONDUCT OR PRACTICE; OR
521+ (V) REVIEWS NOT LESS THA N 10 NONQUANTITATIVE 1
522+TREATMENT LIMITATION S FOR EACH CARRIER R EPORT; AND 2
554523
555- 3. SUBMIT PERIODIC DATA RELATED TO THE CONDU CT
556-OR PRACTICE; OR
557- WES MOORE, Governor Ch. 233
524+ (VI) ISSUES A DETERMINATI ON IN ANY MATTER THAT 3
525+IMPLICATES PARITY ACT COMPLIANCE REGARD LESS OF WHETHER A 4
526+NONQUANTITATIVE TREA TMENT LIMITATION AT ISSUE IN THE MATTER HAS BEEN 5
527+REVIEWED UNDER THIS SECTION. 6
558528
559-– 13 –
560- (II) SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION ,
561-REQUIRE THE CARRIER TO PERFORM A NEW COMPARATIVE ANAL YSIS.
529+ (2) THE COMMISSIONER MAY REQU IRE CARRIERS TO COMP LETE 7
530+DATA TEMPLATES FOR A NONQUANTITATIVE TREATMENT LIMITATION MORE 8
531+FREQUENTLY THAN EVER Y 2 YEARS. 9
562532
563- (3) THE COMMISSIONER MAY REQU IRE THE CARRIER TO E STABLISH
564-SPECIFIC QUANTITATIV E THRESHOLDS FOR EVI DENTIARY STANDARDS A ND
565-CONDUCT A NEW COMPAR ATIVE ANALYSIS FOR A NONQUANTITATIVE TREA TMENT
566-LIMITATION IF THE COMMISSIONER DETERMIN ES A CARRIER FAILED TO PROVIDE A
567-SUFFICIENT COMPARATI VE ANALYSIS BECAUSE THE CARRIER DID NOT :
533+ (j) (1) If the Commissioner finds that the carrier failed to submit a complete 10
534+report required under subsection (c) or (f) of this section, the Commissioner may: 11
568535
569- (I) USE APPLICABLE QUANT ITATIVE THRESHOLDS F OR THE
570-EVIDENTIARY STANDARD ; OR
536+ (I) TAKE ACTION AUTHORIZ ED UNDER PARAGRAPH (2) OF THIS 12
537+SUBSECTION; 13
571538
572- (II) PROVIDE A SPECIFIC , DETAILED, AND REASONED
573-EXPLANATION OF HOW THE CARRIE R ENSURES THAT THE F ACTORS FOR THE
574-NONQUANTITATIVE TREA TMENT LIMITATION ARE BEING APPLIED COMPAR ABLY
575-AND NO MORE STRINGEN TLY TO MENTAL HEALTH AND SUBSTANCE USE DI SORDER
576-SERVICES.
539+ (II) IN ACCORDANCE WITH § 2–208 OF THIS ARTICLE , CHARGE 14
540+THE CARRIER FOR ANY ADDITIONAL EXPENSES INCURRED BY THE COMMISSIONER 15
541+TO REVIEW ADDITIONAL REPORTS; 16
577542
578- (4) SUBSECTION (I)(1)(III) OF THIS SECTION DOES NOT APPLY TO THE
579-FAILURE OF A CARRIER TO SUBMIT A COMPLETE REPORT.
543+ (III) IMPOSE A PENALTY FOR EACH DAY THAT THE CA RRIER 17
544+FAILS TO SUBMIT INFO RMATION REQUIRED BY THE COMMISSIONER TO EVALU ATE 18
545+COMPLIANCE ; OR 19
580546
581- (k) If, as a result of the review required under subsection [(i)(1)] (I)(1)(I) of this
582-section, the Commissioner finds that the carrier failed to comply with [the provisions of]
583-the Parity Act, [and] did not submit a compliance plan to adequately correct the
584-noncompliance, OR FAILED TO SUBMIT INFORMATION THAT IS REQUIRED TO
585-EVALUATE COMPLIANCE WITH THE PARITY ACT, the Commissioner may:
547+ (IV) impose any penalty or take any action as authorized: 20
586548
587- (1) issue an administrative order that requires:
549+ (1) 1. for an insurer, nonprofit health service plan, or any other 21
550+person subject to this section, under this article; or 22
588551
589- (i) the carrier or an entity delegated by the carrier to cease the
590-noncompliant conduct or practice; [or]
552+ (2) 2. for a health maintenance organization, under this article 23
553+or the Health – General Article. 24
591554
592- (II) THE CARRIER OR AN EN TITY DELEGATED BY TH E CARRIER
593-TO CEASE THE IMPLEME NTATION OF THE NONQU ANTITATIVE TREATMENT
594-LIMITATION; OR
555+ (2) IF THE COMMISSIONER CANNOT M AKE A DETERMINATION THAT A 25
556+SPECIFIC CONDUCT OR PRACTICE IS COMPLIAN T WITH THE PARITY ACT BECAUSE 26
557+THE CARRIER FAILED TO PRO VIDE A SUFFICIENT CO MPARATIVE ANALYSIS F OR A 27
558+NONQUANTITATIVE TREA TMENT LIMITATION , THE COMMISSIONER MAY : 28
595559
596- [(ii)] (III) the carrier to provide a payment that has been denied
597-improperly because of the noncompliance, INCLUDING A FAILURE TO PROVIDE
598-INFORMATION THAT DEM ONSTRATES COMPLIANCE ; [or]
560+ (I) ISSUE AN ADMINISTRAT IVE ORDER REQUIRING THE 29
561+CARRIER OR AN ENTITY DELEGATED BY THE CAR RIER TO TAKE THE FOL LOWING 30
562+ACTION UNTIL THE COMMISSIONER CAN MAKE A DETERMINATION OF C OMPLIANCE 31
563+WITH THE PARITY ACT: 32
564+ SENATE BILL 684 13
599565
600- (2) IMPOSE A PENALTY OF NOT LESS THAN $1,000 FOR EACH DAY IN
601-WHICH THE CARRIER FA ILS TO SUBMIT INFORM ATION REQUIRED BY TH E
602-COMMISSIONER TO EVALU ATE COMPLIANCE ; OR
603- Ch. 233 2024 LAWS OF MARYLAND
604566
605-– 14 –
606- [(2)] (3) impose any OTHER penalty or take any action as authorized:
567+ 1. MODIFY THE CONDUCT O R PRACTICE AS SPECIF IED 1
568+BY THE COMMISSIONER ; 2
607569
608- (i) for an insurer, nonprofit health service plan, or any other person
609-subject to this section, under this article; or
570+ 2. CEASE THE CONDUCT OR PRACTICE; OR 3
610571
611- (ii) for a health maintenance organization, under this article or the
612-Health – General Article.
572+ 3. SUBMIT PERIODIC DATA RELATED TO THE CONDU CT 4
573+OR PRACTICE; OR 5
613574
614- (L) (1) A CARRIER SHALL HAVE T HE BURDEN OF PERSUAS ION IN
615-DEMONSTRATING THAT I TS HEALTH PLAN DESIGN AND APPLICATI ON OF A
616-NONQUANTITATIVE TREA TMENT LIMITATION COMPLIES WITH THE PARITY ACT:
575+ (II) SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION , 6
576+REQUIRE THE CARRIER TO PERFORM A NEW COM PARATIVE ANALYSIS . 7
617577
618- (I) IN ANY REVIEW CONDUC TED BY THE COMMISSIONER
619-UNDER THIS SECTION ; OR
578+ (3) THE COMMISSIONER MAY REQU IRE THE CARRIER TO E STABLISH 8
579+SPECIFIC QUANTITATIV E THRESHOLDS FOR EVI DENTIARY STANDARDS A ND 9
580+CONDUCT A NEW COMPARATIVE ANALYSIS FOR A NONQUANTITATIV E TREATMENT 10
581+LIMITATION IF THE COMMISSIONER DETERMIN ES A CARRIER FAILED TO PROVIDE A 11
582+SUFFICIENT COMPARATI VE ANALYSIS BECAUSE THE CARRIER DID NOT : 12
620583
621- (II) IN ANY MATTER FILED WITH COMPLAINT INVESTIGAT ION OR
622-MARKET CONDUCT ACTIO N UNDERTAKEN BY THE COMMISSIONER THAT INVOLVES
623-THE APPLICATION OF T HE PARITY ACT.
584+ (I) USE APPLICABLE QUANT ITATIVE THRESHOLDS F OR THE 13
585+EVIDENTIARY ST ANDARD; OR 14
624586
625- (2) (I) A FAILURE OF A CARRIER TO SUBMIT COMPLETE PARITY
626-ACT COMPLIANCE INFORM ATION REQUIRED UNDER THIS SECTION OR IN
627-CONNECTION WITH A MATTER FILED WITH AN INVESTIGATION OR EXAMINATION BY
628-THE COMMISSIONE R SHALL CONSTITUTE N ONCOMPLIANCE WITH TH E PARITY ACT.
587+ (II) PROVIDE A SPECIFIC , DETAILED, AND REASONED 15
588+EXPLANATION OF HOW T HE CARRIER ENSURES T HAT THE FACTORS FOR THE 16
589+NONQUANTITATIVE TREA TMENT LIMITATION ARE BEING APPLIED COMPAR ABLY 17
590+AND NO MORE STRINGEN TLY TO MENTAL HEALTH AND SUBSTANCE USE DI SORDER 18
591+SERVICES. 19
629592
630- (II) SUBSECTION (I)(1)(III) OF THIS SECTION DOES NOT APPLY
631-TO A CARRIER THAT FA ILS TO SUBMIT COMPLE TE PARITY ACT COMPLIANCE
632-INFORMATION .
593+ (4) SUBSECTION (I)(1)(III) OF THIS SECTION DOES NOT APPLY TO THE 20
594+FAILURE OF A CARRIER TO SUBMIT A COMPLETE REPORT. 21
633595
634- [(l)] (M) In determining an appropriate penalty under subsection (j) or (k) of this
635-section, the Commissioner shall consider the late filing of a report required under
636-subsection (c) or (f) of this section and any parity violation to be a serious violation with a
637-significantly deleterious effect on the public.
596+ (k) If, as a result of the review required under subsection [(i)(1)] (I)(1)(I) of this 22
597+section, the Commissioner finds that the carrier failed to comply with [the provisions of] 23
598+the Parity Act, [and] did not submit a compliance plan to adequately correct the 24
599+noncompliance, OR FAILED TO SUBMIT INFORMATION THAT IS REQUIRED TO 25
600+EVALUATE COMPLIANCE WITH THE PARITY ACT, the Commissioner may: 26
638601
639- [(m)] (N) On or before December 31, 2021, the THE Commissioner shall create:
602+ (1) issue an administrative order that requires: 27
640603
641- (1) a standard form for entities to submit the reports in accordance with
642-subsection (g)(1) of this section; and
604+ (i) the carrier or an entity delegated by the carrier to cease the 28
605+noncompliant conduct or practice; [or] 29
643606
644- (2) a summary form for entities to post to their websites in accordance with
645-subsection (g)(5) of this section.
607+ (II) THE CARRIER OR AN EN TITY DELEGATED BY THE CAR RIER 30
608+TO CEASE THE IMPLEME NTATION OF THE NONQU ANTITATIVE TREATMENT 31
609+LIMITATION; OR 32
610+ 14 SENATE BILL 684
646611
647- [(n)] (O) On or before December 31, [2021] 2024, the THE Commissioner shall,
648-in consultation with interested stakeholders, adopt regulations to implement this section, WES MOORE, Governor Ch. 233
649612
650-– 15 –
651-including to ensure uniform definitions and methodology for the reporting requirements
652-established under this section.
613+ [(ii)] (III) the carrier to provide a payment that has been denied 1
614+improperly because of the noncompliance, INCLUDING A FAILURE TO PROVIDE 2
615+INFORMATION THAT DEMONSTRATES CO MPLIANCE; [or] 3
653616
654-15–1309.
617+ (2) IMPOSE A PENALTY OF NOT LESS THAN $1,000 FOR EACH DAY IN 4
618+WHICH THE CARRIER FA ILS TO SUBMIT INFORM ATION REQUIRED BY TH E 5
619+COMMISSIONER TO EVALU ATE COMPLIANCE ; OR 6
655620
656- (a) (1) In this section the following words have the meanings indicated.
621+ [(2)] (3) impose any OTHER penalty or take any action as authorized: 7
657622
658- (3) (i) “Product” means a discrete package of health benefits that are
659-offered using a particular product network type within a geographic service area.
623+ (i) for an insurer, nonprofit health service plan, or any other person 8
624+subject to this section, under this article; or 9
660625
661- (ii) “Product” comprises all plans offered within the product.
626+ (ii) for a health maintenance organization, under this article or the 10
627+Health – General Article. 11
662628
663-Chapter 211 of the Acts of 2020
629+ (L) (1) A CARRIER SHALL HAVE T HE BURDEN OF PERSUAS ION IN 12
630+DEMONSTRATING THAT I TS HEALTH PLAN DESIGN AND APPLICATI ON OF A 13
631+NONQUANTITATIVE TREA TMENT LIMITATION COMPLIES WITH THE PARITY ACT: 14
664632
665- [SECTION 2. AND B E IT FURTHER ENACTED, That the standard form the
666-Maryland Insurance Commissioner is required to develop under § 15–144(m)(1) of the
667-Insurance Article, as enacted by Section 1 of this Act, for the report required under §
668-15–144(c) of the Insurance Article, as enacted by Section 1 of this Act, shall be the National
669-Association of Insurance Commissioners’ Data Collection Tool for Mental Health Parity
670-Analysis, Nonquantitative Treatment Limitations and any amendments by the
671-Commissioner to the tool necessary to incorporate the requirements of § 15–144(c), (d), and
672-(e) of the Insurance Article, as enacted by Section 1 of this Act.]
633+ (I) IN ANY REVIEW CONDUC TED BY THE COMMISSIONER 15
634+UNDER THIS SECTION ; OR 16
673635
674- SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect
675-October 1, 2020. [It shall remain in effect for a period of 6 years and, at the end of
676-September 30, 2026, this Act, with no further action required by the General Assembly,
677-shall be abrogated and of no further force and effect.]
636+ (II) IN ANY MATTER FILED WITH COMPLAINT INVESTIGAT ION OR 17
637+MARKET CONDUCT ACTIO N UNDERTAKEN BY THE COMMISSIONER THAT INV OLVES 18
638+THE APPLICATION OF T HE PARITY ACT. 19
678639
679-Chapter 212 of the Acts of 2020
640+ (2) (I) A FAILURE OF A CARRIER TO SUBMIT COMPLETE PARITY 20
641+ACT COMPLIANCE INFORM ATION REQUIRED UNDER THIS SECTION OR IN 21
642+CONNECTION WITH A MATTER FILED WITH AN INVESTIGATION OR EXAMINATION BY 22
643+THE COMMISSIONER SHALL CO NSTITUTE NONCOMPLIAN CE WITH THE PARITY ACT. 23
680644
681- [SECTION 2. AND BE IT FURTHER ENACTED, That the st andard form the
682-Maryland Insurance Commissioner is required to develop under § 15–144(m)(1) of the
683-Insurance Article, as enacted by Section 1 of this Act, for the report required under §
684-15–144(c) of the Insurance Article, as enacted by Section 1 of this Act, shall be the National
685-Association of Insurance Commissioners’ Data Collection Tool for Mental Health Parity
686-Analysis, Nonquantitative Treatment Limitations and any amendments by the
687-Commissioner to the tool necessary to incorporate the requirements of § 15–144(c), (d), and
688-(e) of the Insurance Article, as enacted by Section 1 of this Act.]
645+ (II) SUBSECTION (I)(1)(III) OF THIS SECTION DOES NOT APPLY 24
646+TO A CARRIER THAT FA ILS TO SUBMIT COMPLE TE PARITY ACT COMPLIANCE 25
647+INFORMATION . 26
689648
690- SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect
691-October 1, 2020. [It shall remain in effect for a period of 6 years and, at the end of
692-September 30, 2026, this Act, with no further action required by the General Assembly,
693-shall be abrogated and of no further force and effect.]
649+ [(l)] (M) In determining an appropriate penalty under subsection (j) or (k) of this 27
650+section, the Commissioner shall consider the late filing of a report required under 28
651+subsection (c) or (f) of this section and any parity violation to be a serious violation with a 29
652+significantly deleterious effect on the public. 30
694653
695- SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July
696-1, 2024 is an emergency measure, is necessary for the immediate preservation of the public Ch. 233 2024 LAWS OF MARYLAND
654+ [(m)] (N) On or before December 31, 2021, the THE Commissioner shall create: 31
697655
698-– 16 –
699-health or safety, has been passed by a yea and nay vote supported by three–fifths of all the
700-members elected to each of the two Houses of the General Assembly, and shall take effect
701-from the date it is enacted.
656+ (1) a standard form for entities to submit the reports in accordance with 32
657+subsection (g)(1) of this section; and 33 SENATE BILL 684 15
702658
703-Approved by the Governor, April 25, 2024.
659+
660+
661+ (2) a summary form for entities to post to their websites in accordance with 1
662+subsection (g)(5) of this section. 2
663+
664+ [(n)] (O) On or before December 31, [2021] 2024, the THE Commissioner shall, 3
665+in consultation with interested stakeholders, adopt regulations to implement this section, 4
666+including to ensure uniform definitions and methodology for the reporting requirements 5
667+established under this section. 6
668+
669+15–1309. 7
670+
671+ (a) (1) In this section the following words have the meanings indicated. 8
672+
673+ (3) (i) “Product” means a discrete package of health benefits that are 9
674+offered using a particular product network type within a geographic service area. 10
675+
676+ (ii) “Product” comprises all plans offered within the product. 11
677+
678+Chapter 211 of the Acts of 2020 12
679+
680+ [SECTION 2. AND B E IT FURTHER ENACTED, That the standard form the 13
681+Maryland Insurance Commissioner is required to develop under § 15–144(m)(1) of the 14
682+Insurance Article, as enacted by Section 1 of this Act, for the report required under § 15
683+15–144(c) of the Insurance Article, as enacted by Section 1 of this Act, shall be the National 16
684+Association of Insurance Commissioners’ Data Collection Tool for Mental Health Parity 17
685+Analysis, Nonquantitative Treatment Limitations and any amendments by the 18
686+Commissioner to the tool necessary to incorporate the requirements of § 15–144(c), (d), and 19
687+(e) of the Insurance Article, as enacted by Section 1 of this Act.] 20
688+
689+ SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
690+October 1, 2020. [It shall remain in effect for a period of 6 years and, at the end of 22
691+September 30, 2026, this Act, with no further action required by the General Assembly, 23
692+shall be abrogated and of no further force and effect.] 24
693+
694+Chapter 212 of the Acts of 2020 25
695+
696+ [SECTION 2. AND BE IT FURTHER ENACTED, That the st andard form the 26
697+Maryland Insurance Commissioner is required to develop under § 15–144(m)(1) of the 27
698+Insurance Article, as enacted by Section 1 of this Act, for the report required under § 28
699+15–144(c) of the Insurance Article, as enacted by Section 1 of this Act, shall be the National 29
700+Association of Insurance Commissioners’ Data Collection Tool for Mental Health Parity 30
701+Analysis, Nonquantitative Treatment Limitations and any amendments by the 31
702+Commissioner to the tool necessary to incorporate the requirements of § 15–144(c), (d), and 32
703+(e) of the Insurance Article, as enacted by Section 1 of this Act.] 33
704+ 16 SENATE BILL 684
705+
706+
707+ SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 1
708+October 1, 2020. [It shall remain in effect for a period of 6 years and, at the end of 2
709+September 30, 2026, this Act, with no further action required by the General Assembly, 3
710+shall be abrogated and of no further force and effect.] 4
711+
712+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 5
713+1, 2024 is an emergency measure, is necessary for the immediate preservation of the public 6
714+health or safety, has been passed by a yea and nay vote supported by three–fifths of all the 7
715+members elected to each of the two Houses of the General Assembly, and shall take effect 8
716+from the date it is enacted. 9
717+
718+
719+
720+Approved:
721+________________________________________________________________________________
722+ Governor.
723+________________________________________________________________________________
724+ President of the Senate.
725+________________________________________________________________________________
726+ Speaker of the House of Delegates.