EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1086*
HOUSE BILL 1086
J5 5lr2839
By: Delegates Martinez, Pena–Melnyk, Alston, Lehman, Roberts, Taveras, Taylor,
and Turner
Introduced and read first time: February 5, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Maryland Medical Assistance Program and Health Insurance – Coverage for 2
Anesthesia – Prohibiting Time Limitations 3
FOR the purpose of requiring the Maryland Medical Assistance Program, managed care 4
organizations, and certain insurers, nonprofit health service plans, and health 5
maintenance organizations, if providing coverage for the delivery of anesthesia for a 6
procedure for which a licensed medical professional issues an order, to provide the 7
coverage in a certain manner; and generally relating to health insurance coverage 8
for the delivery of anesthesia. 9
BY adding to 10
Article – Health – General 11
Section 15–102.3(m), 15–103(a)(2)(xxv), and 15–157 12
Annotated Code of Maryland 13
(2023 Replacement Volume and 2024 Supplement) 14
BY repealing and reenacting, without amendments, 15
Article – Health – General 16
Section 15–103(a)(1) 17
Annotated Code of Maryland 18
(2023 Replacement Volume and 2024 Supplement) 19
BY repealing and reenacting, with amendments, 20
Article – Health – General 21
Section 15–103(a)(2)(xxiii) and (xxiv) 22
Annotated Code of Maryland 23
(2023 Replacement Volume and 2024 Supplement) 24
BY adding to 25
Article – Insurance 26 2 HOUSE BILL 1086
Section 15–861 1
Annotated Code of Maryland 2
(2017 Replacement Volume and 2024 Supplement) 3
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4
That the Laws of Maryland read as follows: 5
Article – Health – General 6
15–102.3. 7
(M) BEGINNING JANUARY 1, 2026, THE PROVISIONS OF § 15–861 OF THE 8
INSURANCE ARTICLE APPLY TO MANA GED CARE ORGANIZATIO NS IN THE SAME 9
MANNER THAT THEY APP LY TO CARRIERS. 10
15–103. 11
(a) (1) The Secretary shall administer the Maryland Medical Assistance 12
Program. 13
(2) The Program: 14
(xxiii) Beginning on July 1, 2025, shall provide, subject to the 15
limitations of the State budget, and as permitted by federal law, coverage for biomarker 16
testing in accordance with § 15–859 of the Insurance Article; [and] 17
(xxiv) Beginning on January 1, 2025, shall provide coverage for 18
prostheses in accordance with § 15–844 of the Insurance Article; AND 19
(XXV) BEGINNING ON JANUARY 1, 2026, IF PROVIDING COVERAG E 20
FOR THE DELIVERY OF ANESTHESIA, SHALL PROVIDE COVERA GE FOR THE DELIVERY 21
OF ANESTHESIA IN ACC ORDANCE WITH § 15–861 OF THE INSURANCE ARTICLE. 22
15–157. 23
IF THE PROGRAM COVERS THE DELIVERY OF ANESTHESIA FOR A PROCEDURE 24
FOR WHICH A LICENSED MEDICAL PROFESSIONAL ISSUES AN ORDER , THE 25
PROGRAM: 26
(1) SHALL PROVIDE COVERAGE FOR THE DELIVERY OF ANES THESIA 27
FOR THE ENTIRE DURAT ION OF THE PROCEDURE ; AND 28
(2) MAY NOT PLACE TIME LIMIT ATIONS ON THE DELIVE RY OF 29
ANESTHESIA. 30
HOUSE BILL 1086 3
Article – Insurance 1
15–861. 2
(A) THIS SECTION APPLIES TO: 3
(1) INSURERS AND NONPROF IT HEALTH SERVICE PLANS THAT 4
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 5
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 6
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 7
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PROVIDE 8
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 9
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 10
(B) AN ENTITY SUBJECT TO TH IS SECTION THAT COVERS THE DELI VERY OF 11
ANESTHESIA FOR A PRO CEDURE FOR WHICH A L ICENSED MEDICAL PROFESSIONAL 12
ISSUES AN ORDER : 13
(1) SHALL PROVIDE COVERA GE FOR THE DELIVERY OF ANESTHESIA 14
FOR THE ENTIRE DURAT ION OF THE PROCEDURE ; AND 15
(2) MAY NOT PLACE TIME L IMITATIONS ON THE DE LIVERY OF 16
ANESTHESIA. 17
SECTION 2. AND BE IT FURTHER ENACTED, T hat this Act shall apply to all 18
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 19
after January 1, 2026. 20
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 21
January 1, 2026. 22