| Old | New | Differences | |
|---|---|---|---|
| 1 | 1 | ||
| 2 | 2 | ||
| 3 | 3 | EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW. | |
| 4 | 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 | 5 | *hb0011* | |
| 9 | 6 | ||
| 10 | 7 | HOUSE BILL 11 | |
| 11 | 8 | J5, J4 5lr1407 | |
| 12 | - | (PRE–FILED) CF SB 902 | |
| 13 | - | By: Delegate Sample–Hughes Delegates Sample–Hughes, Alston, Bagnall , | |
| 14 | - | Bhandari, Chisholm, Cullison, Guzzone, Hill, Hutchinson, S. Johnson, | |
| 15 | - | Kaiser, Kerr, Kipke, Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, | |
| 16 | - | Rosenberg, Szeliga, Taveras, White Holland, Woods, and Woorman | |
| 9 | + | (PRE–FILED) CF 5lr1408 | |
| 10 | + | By: Delegate Sample–Hughes | |
| 17 | 11 | Requested: October 18, 2024 | |
| 18 | 12 | Introduced and read first time: January 8, 2025 | |
| 19 | 13 | Assigned to: Health and Government Operations | |
| 20 | - | Committee Report: Favorable with amendments | |
| 21 | - | House action: Adopted | |
| 22 | - | Read second time: February 22, 2025 | |
| 23 | 14 | ||
| 24 | - | ||
| 15 | + | A BILL ENTITLED | |
| 25 | 16 | ||
| 26 | 17 | AN ACT concerning 1 | |
| 27 | 18 | ||
| 28 | 19 | Health Insurance – Access to Nonparticipating Providers – Referrals, Additional 2 | |
| 29 | 20 | Assistance, and Coverage 3 | |
| 30 | 21 | ||
| 31 | 22 | FOR the purpose of repealing the termination date for certain provisions of law related to 4 | |
| 32 | 23 | referrals to and reimbursement of specialists and nonphysician specialists who are 5 | |
| 33 | 24 | not part of a carrier’s provider panel; requiring that a certain referral procedure 6 | |
| 34 | 25 | required to be established and implemented by certain insurers, nonprofit health 7 | |
| 35 | 26 | service plans, and health maintenance organizations require the carrier to provide 8 | |
| 36 | 27 | certain assistance to a member in identifying and arranging coverage for a specialist 9 | |
| 37 | - | or nonphysician specialist for treatment of | |
| 28 | + | or nonphysician specialist for treatment of mental health or substance use disorder 10 | |
| 38 | 29 | services; prohibiting certain carriers from imposing prior authorization 11 | |
| 39 | 30 | requirements for scheduling, reimbursing, or continuing an established treatment 12 | |
| 40 | - | plan by certain nonparticipating providers utilization review requirements other 13 | |
| 41 | - | than what would be required if the covered benefit was provided by a provider on the 14 | |
| 42 | - | carrier’s provider panel under certain circumstances; requiring the Maryland Health 15 | |
| 43 | - | Care Commission to establish certain reimbursement rates for nonparticipating 16 | |
| 44 | - | providers; and generally relating to access to nonparticipating providers. 17 | |
| 31 | + | plan by certain nonparticipating providers; requiring the Maryland Health Care 13 | |
| 32 | + | Commission to establish certain reimbursement rates for nonparticipating 14 | |
| 33 | + | providers; and generally relating to access to nonparticipating providers. 15 | |
| 45 | 34 | ||
| 46 | - | BY repealing and reenacting, without amendments, 18 | |
| 47 | - | Article – Insurance 19 | |
| 48 | - | Section 15–830(a) 20 2 HOUSE BILL 11 | |
| 35 | + | BY repealing and reenacting, without amendments, 16 | |
| 36 | + | Article – Insurance 17 | |
| 37 | + | Section 15–830(a) 18 | |
| 38 | + | Annotated Code of Maryland 19 | |
| 39 | + | (2017 Replacement Volume and 2024 Supplement) 20 | |
| 40 | + | ||
| 41 | + | BY repealing and reenacting, with amendments, 21 | |
| 42 | + | Article – Insurance 22 | |
| 43 | + | Section 15–830(d) and (e) 23 | |
| 44 | + | Annotated Code of Maryland 24 | |
| 45 | + | (2017 Replacement Volume and 2024 Supplement) 25 | |
| 46 | + | ||
| 47 | + | BY repealing and reenacting, with amendments, 26 | |
| 48 | + | Chapter 271 of the Acts of the General Assembly of 2022 27 2 HOUSE BILL 11 | |
| 49 | 49 | ||
| 50 | 50 | ||
| 51 | - | Annotated Code of Maryland 1 | |
| 52 | - | (2017 Replacement Volume and 2024 Supplement) 2 | |
| 51 | + | Section 4 1 | |
| 53 | 52 | ||
| 54 | - | BY repealing and reenacting, with amendments, 3 | |
| 55 | - | Article – Insurance 4 | |
| 56 | - | Section 15–830(d) and (e) 5 | |
| 57 | - | Annotated Code of Maryland 6 | |
| 58 | - | (2017 Replacement Volume and 2024 Supplement) 7 | |
| 53 | + | BY repealing and reenacting, with amendments, 2 | |
| 54 | + | Chapter 272 of the Acts of the General Assembly of 2022 3 | |
| 55 | + | Section 4 4 | |
| 59 | 56 | ||
| 60 | - | BY repealing and reenacting, with amendments, 8 | |
| 61 | - | Chapter 271 of the Acts of the General Assembly of 2022 9 | |
| 62 | - | Section 4 10 | |
| 57 | + | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5 | |
| 58 | + | That the Laws of Maryland read as follows: 6 | |
| 63 | 59 | ||
| 64 | - | BY repealing and reenacting, with amendments, 11 | |
| 65 | - | Chapter 272 of the Acts of the General Assembly of 2022 12 | |
| 66 | - | Section 4 13 | |
| 60 | + | Article – Insurance 7 | |
| 67 | 61 | ||
| 68 | - | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14 | |
| 69 | - | That the Laws of Maryland read as follows: 15 | |
| 62 | + | 15–830. 8 | |
| 70 | 63 | ||
| 71 | - | ||
| 64 | + | (a) (1) In this section the following words have the meanings indicated. 9 | |
| 72 | 65 | ||
| 73 | - | ||
| 66 | + | (2) “Carrier” means: 10 | |
| 74 | 67 | ||
| 75 | - | (a) (1) In this section the following words have the meanings indicated. 18 | |
| 68 | + | (i) an insurer that offers health insurance other than long–term 11 | |
| 69 | + | care insurance or disability insurance; 12 | |
| 76 | 70 | ||
| 77 | - | ( | |
| 71 | + | (ii) a nonprofit health service plan; 13 | |
| 78 | 72 | ||
| 79 | - | (i) an insurer that offers health insurance other than long–term 20 | |
| 80 | - | care insurance or disability insurance; 21 | |
| 73 | + | (iii) a health maintenance organization; 14 | |
| 81 | 74 | ||
| 82 | - | ( | |
| 75 | + | (iv) a dental plan organization; or 15 | |
| 83 | 76 | ||
| 84 | - | (iii) a health maintenance organization; 23 | |
| 77 | + | (v) except for a managed care organization as defined in Title 15, 16 | |
| 78 | + | Subtitle 1 of the Health – General Article, any other person that provides health benefit 17 | |
| 79 | + | plans subject to State regulation. 18 | |
| 85 | 80 | ||
| 86 | - | (iv) a dental plan organization; or 24 | |
| 81 | + | (3) (i) “Member” means an individual entitled to health care benefits 19 | |
| 82 | + | under a policy or plan issued or delivered in the State by a carrier. 20 | |
| 87 | 83 | ||
| 88 | - | (v) except for a managed care organization as defined in Title 15, 25 | |
| 89 | - | Subtitle 1 of the Health – General Article, any other person that provides health benefit 26 | |
| 90 | - | plans subject to State regulation. 27 | |
| 84 | + | (ii) “Member” includes a subscriber. 21 | |
| 91 | 85 | ||
| 92 | - | (3) (i) “Member” means an individual entitled to health care benefits 28 | |
| 93 | - | under a policy or plan issued or delivered in the State by a carrier. 29 | |
| 86 | + | (4) “Nonphysician specialist” means a health care provider: 22 | |
| 94 | 87 | ||
| 95 | - | ( | |
| 88 | + | (i) 1. who is not a physician; 23 | |
| 96 | 89 | ||
| 97 | - | (4) “Nonphysician specialist” means a health care provider: 31 HOUSE BILL 11 3 | |
| 90 | + | 2. who is licensed or certified under the Health Occupations 24 | |
| 91 | + | Article; and 25 | |
| 92 | + | ||
| 93 | + | 3. who is certified or trained to treat or provide health care 26 | |
| 94 | + | services for a specified condition or disease in a manner that is within the scope of the 27 | |
| 95 | + | license or certification of the health care provider; or 28 | |
| 96 | + | HOUSE BILL 11 3 | |
| 98 | 97 | ||
| 99 | 98 | ||
| 99 | + | (ii) that is licensed as a behavioral health program under § 7.5–401 1 | |
| 100 | + | of the Health – General Article. 2 | |
| 100 | 101 | ||
| 101 | - | (i) 1. who is not a physician; 1 | |
| 102 | + | (5) (i) “Provider panel” means the providers that contract with a carrier 3 | |
| 103 | + | either directly or through a subcontracting entity to provide health care services to 4 | |
| 104 | + | enrollees of the carrier. 5 | |
| 102 | 105 | ||
| 103 | - | 2. who is licensed or certified under the Health Occupations 2 | |
| 104 | - | Article; and 3 | |
| 106 | + | (ii) “Provider panel” does not include an arrangement in which any 6 | |
| 107 | + | provider may participate solely by contracting with the carrier to provide health care 7 | |
| 108 | + | services at a discounted fee–for–service rate. 8 | |
| 105 | 109 | ||
| 106 | - | | |
| 107 | - | ||
| 108 | - | ||
| 110 | + | (6) “Specialist” means a physician who is certified or trained to practice in 9 | |
| 111 | + | a specified field of medicine and who is not designated as a primary care provider by the 10 | |
| 112 | + | carrier. 11 | |
| 109 | 113 | ||
| 110 | - | (ii) that is licensed as a behavioral health program under § 7.5–401 7 | |
| 111 | - | of the Health – General Article. 8 | |
| 114 | + | (d) (1) Each carrier shall establish and implement a procedure by which a 12 | |
| 115 | + | member may request a referral to a specialist or nonphysician specialist who is not part of 13 | |
| 116 | + | the carrier’s provider panel in accordance with this subsection. 14 | |
| 112 | 117 | ||
| 113 | - | (5) (i) “Provider panel” means the providers that contract with a carrier 9 | |
| 114 | - | either directly or through a subcontracting entity to provide health care services to 10 | |
| 115 | - | enrollees of the carrier. 11 | |
| 118 | + | (2) The procedure shall provide for a referral to a specialist or nonphysician 15 | |
| 119 | + | specialist who is not part of the carrier’s provider panel if: 16 | |
| 116 | 120 | ||
| 117 | - | (ii) “Provider panel” does not include an arrangement in which any 12 | |
| 118 | - | provider may participate solely by contracting with the carrier to provide health care 13 | |
| 119 | - | services at a discounted fee–for–service rate. 14 | |
| 121 | + | (i) the member is diagnosed with OR SEEKING CARE FOR a 17 | |
| 122 | + | condition or disease that requires specialized health care services or medical care; and 18 | |
| 120 | 123 | ||
| 121 | - | ( | |
| 122 | - | ||
| 123 | - | ||
| 124 | + | (ii) 1. the carrier does not have in its provider panel a specialist 19 | |
| 125 | + | or nonphysician specialist with the professional training and expertise to treat or provide 20 | |
| 126 | + | health care services for the condition or disease; or 21 | |
| 124 | 127 | ||
| 125 | - | (d) (1) Each carrier shall establish and implement a procedure by which a 18 | |
| 126 | - | member may request a referral to a specialist or nonphysician specialist who is not part of 19 | |
| 127 | - | the carrier’s provider panel in accordance with this subsection. 20 | |
| 128 | + | 2. the carrier cannot provide reasonable access to a specialist 22 | |
| 129 | + | or nonphysician specialist with the professional training and expertise to treat or provide 23 | |
| 130 | + | health care services for the condition or disease [without unreasonable delay or travel] 24 | |
| 131 | + | WITHIN THE REASONABLE APPOINTME NT WAITING TIME AND TRAVEL DISTANCE 25 | |
| 132 | + | STANDARDS ESTABLISHE D IN REGULATION . 26 | |
| 128 | 133 | ||
| 129 | - | (2) The procedure shall provide for a referral to a specialist or nonphysician 21 | |
| 130 | - | specialist who is not part of the carrier’s provider panel if: 22 | |
| 134 | + | (3) The procedure shall ensure that a request to obtain a referral to a 27 | |
| 135 | + | specialist or nonphysician specialist who is not part of the carrier’s provider panel is 28 | |
| 136 | + | addressed in a timely manner that is: 29 | |
| 131 | 137 | ||
| 132 | - | (i) 1. the member is diagnosed with OR SEEKING CARE FOR a 23 | |
| 133 | - | condition or disease that requires specialized health care services or medical care; and 24 | |
| 138 | + | (i) appropriate for the member’s condition; and 30 | |
| 134 | 139 | ||
| 135 | - | (ii) 1. 2. A. the carrier does not have in its provider panel a 25 | |
| 136 | - | specialist or nonphysician specialist with the professional training and expertise to treat or 26 | |
| 137 | - | provide health care services for the condition or disease; or 27 | |
| 140 | + | (ii) in accordance with t he timeliness requirements for 31 | |
| 141 | + | determinations made by private review agents under § 15–10B–06 of this title. 32 | |
| 138 | 142 | ||
| 139 | - | 2. B. the carrier cannot provide reasonable access to a specialist 28 | |
| 140 | - | or nonphysician specialist with the professional training and expertise to treat or provide 29 | |
| 141 | - | health care services for the condition or disease [without unreasonable delay or travel], 30 | |
| 142 | - | INCLUDING WITHIN THE REASONABL E APPOINTMENT WAITIN G TIME AND TRAVEL 31 | |
| 143 | - | DISTANCE STANDARDS E STABLISHED IN REGULAT ION FOR MENTAL HEALTH AN D 32 | |
| 144 | - | SUBSTANCE USE DISORD ER SERVICES; OR 33 | |
| 145 | - | 4 HOUSE BILL 11 | |
| 143 | + | (4) IF A MEMBER CANNOT ACCESS MENTAL HEALTH OR SUB STANCE 33 | |
| 144 | + | USE DISORDER SERVICE S THROUGH THE REFERRAL REQUIREMENTS UNDER 34 4 HOUSE BILL 11 | |
| 146 | 145 | ||
| 147 | 146 | ||
| 148 | - | (II) 1. THE MEMBER IS SEEKIN G MENTAL HEALTH OR 1 | |
| 149 | - | SUBSTANCE USE DISORD ER CARE; AND 2 | |
| 147 | + | PARAGRAPHS (2) AND (3) OF THIS SUBSECTION , THE PROCEDURE SHALL REQUIRE 1 | |
| 148 | + | THE CARRIER TO PROVI DE ADDITIONAL ASSISTANC E TO THE MEMBER IN 2 | |
| 149 | + | IDENTIFYING AND ARRA NGING COVERAGE OF MENTAL HEALTH OR SUB STANCE USE 3 | |
| 150 | + | DISORDER SERV ICES BY A SPECIALIST OR NONP HYSICIAN SPECIALIST WHO IS NOT 4 | |
| 151 | + | PART OF THE CARRIER ’S PROVIDER PANEL . 5 | |
| 150 | 152 | ||
| 151 | - | 2. THE CARRIER CANNOT P ROVIDE REASONABLE 3 | |
| 152 | - | ACCESS TO A SPECIALI ST OR NONPHYSICIAN S PECIALIST WITHIN THE RE ASONABLE 4 | |
| 153 | - | APPOINTMENT WAITING TIME AND TRAVEL DIST ANCE STANDARDS ESTAB LISHED IN 5 | |
| 154 | - | REGULATION FOR MENTA L HEALTH AND SUBSTAN CE USE DISORDER SERV ICES. 6 | |
| 153 | + | (5) THE PROCEDURE MAY NOT REQUIRE PRIOR AUTHOR IZATION FOR 6 | |
| 154 | + | PURPOSES OF: 7 | |
| 155 | 155 | ||
| 156 | - | (3) The procedure shall ensure that a request to obtain a referral to a 7 | |
| 157 | - | specialist or nonphysician specialist who is not part of the carrier’s provider panel is 8 | |
| 158 | - | addressed in a timely manner that is: 9 | |
| 156 | + | (I) SCHEDULING AN APPOINTMENT WITH A SPECIALIST OR 8 | |
| 157 | + | NONPHYSICIAN SPECIAL IST WHO IS NOT PART OF THE C ARRIER’S PROVIDER PANEL ; 9 | |
| 159 | 158 | ||
| 160 | - | (i) appropriate for the member’s condition; and 10 | |
| 159 | + | (II) REIMBURSING A SPECIALIST OR NONPHYSICIAN SPEC IALIST 10 | |
| 160 | + | WHO IS NOT PART OF THE C ARRIER’S PROVIDER PANEL ; OR 11 | |
| 161 | 161 | ||
| 162 | - | (ii) in accordance with the timeliness requirements for 11 | |
| 163 | - | determinations made by private review agents under § 15–10B–06 of this title. 12 | |
| 162 | + | (III) CONTINUING AN ESTABLISHED TREAT MENT PLAN WITH A 12 | |
| 163 | + | SPECIALIST OR NONPHY SICIAN SPECIALIST WHO IS NOT PART OF THE C ARRIER’S 13 | |
| 164 | + | PROVIDER PANEL . 14 | |
| 164 | 165 | ||
| 165 | - | (4) IF A MEMBER CANNOT AC CESS MENTAL HEALTH O R SUBSTANCE 13 | |
| 166 | - | USE DISORDER SERVICE S THROUGH THE REFERR AL REQUIREMENTS UNDE R 14 | |
| 167 | - | PARAGRAPHS (2) AND (3) OF THIS SUBSECTION , THE PROCEDURE SHALL REQUIRE 15 | |
| 168 | - | THE CARRIER TO P ROVIDE ADDITIONAL AS SISTANCE TO THE MEMB ER IN 16 | |
| 169 | - | IDENTIFYING AND ARRA NGING COVERAGE OF ME NTAL HEALTH OR SUBST ANCE USE 17 | |
| 170 | - | DISORDER SERVICES BY A SPECIALIST OR NONP HYSICIAN SPECIALIST WHO IS NOT 18 | |
| 171 | - | PART OF THE CARRIER ’S PROVIDER PANEL . 19 | |
| 166 | + | [(4)] (6) The procedure may not be used by a carrier as a substitute for 15 | |
| 167 | + | establishing and maintaining a sufficient provider network in accordance with § 15–112 of 16 | |
| 168 | + | this title. 17 | |
| 172 | 169 | ||
| 173 | - | (5) THE PROCEDURE MAY NOT REQUIRE PRIOR AUTHORI ZATION FOR 20 | |
| 174 | - | PURPOSES OF: 21 | |
| 170 | + | [(5)] (7) Each carrier shall: 18 | |
| 175 | 171 | ||
| 176 | - | (I) SCHEDULING AN APPOIN TMENT WITH A SPECIAL IST OR 22 | |
| 177 | - | NONPHYSICIAN SPECIAL IST WHO IS NOT PART OF THE CARRIER ’S PROVIDER PANEL ; 23 | |
| 172 | + | (i) have a system in place that documents all requests to obtain a 19 | |
| 173 | + | referral to receive a covered service from a specialist or nonphysician specialist who is not 20 | |
| 174 | + | part of the carrier’s provider panel; 21 | |
| 178 | 175 | ||
| 179 | - | (II) | |
| 180 | - | ||
| 176 | + | (ii) inform members of the procedure to request a referral under 22 | |
| 177 | + | paragraph (1) of this subsection; and 23 | |
| 181 | 178 | ||
| 182 | - | (III) CONTINUING AN ESTABL ISHED TREATMENT PLAN WITH A 26 | |
| 183 | - | SPECIALIST OR NONPHY SICIAN SPECIALIST WH O IS NOT PART OF THE CARRIER’S 27 | |
| 184 | - | PROVIDER PANEL IF A CARRIER APPROVES A MEMBER’S REQUEST FOR A REFE RRAL 28 | |
| 185 | - | MADE IN ACCORDANCE W ITH THIS SUBSECTION, THE CARRIER MAY NOT REQUIRE 29 | |
| 186 | - | UTILIZATION REVIEW O THER THAN WHAT WOULD BE REQUIRED IF THE C OVERED 30 | |
| 187 | - | BENEFIT WERE PROVIDE D BY A PROVIDER ON T HE CARRIER’S PROVIDER PANEL . 31 | |
| 179 | + | (iii) provide the information documented under item (i) of this 24 | |
| 180 | + | paragraph to the Commissioner on request. 25 | |
| 188 | 181 | ||
| 189 | - | [(4)] (6) The procedure may not be used by a carrier as a substitute for 32 | |
| 190 | - | establishing and maintaining a sufficient provider network in accordance with § 15–112 of 33 | |
| 191 | - | this title. 34 | |
| 182 | + | (e) (1) Except as provided in paragraph (2) of this subsection, for purposes of 26 | |
| 183 | + | calculating any deductible, copayment amount, or coinsurance payable by the member, a 27 | |
| 184 | + | carrier shall treat services received in accordance with subsection (d) of this section as if 28 | |
| 185 | + | the service was provided by a provider on the carrier’s provider panel. 29 | |
| 186 | + | ||
| 187 | + | (2) A carrier shall ensure that services received in accordance with 30 | |
| 188 | + | subsection (d) of this section for mental health or substance use disorders are provided FOR 31 | |
| 189 | + | THE DURATION OF THE TREATMENT PLAN at no greater cost to the covered individual 32 | |
| 190 | + | than if the covered benefit were provided by a provider on the carrier’s provider panel. 33 | |
| 192 | 191 | HOUSE BILL 11 5 | |
| 193 | 192 | ||
| 194 | 193 | ||
| 195 | - | [(5)] (7) Each carrier shall: 1 | |
| 194 | + | (3) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , AND 1 | |
| 195 | + | NOT LATER THAN JANUARY 1, 2026, THE MARYLAND HEALTH CARE COMMISSION 2 | |
| 196 | + | SHALL ESTABLISH A RE IMBURSEMENT FORMULA TO DETERMINE T HE 3 | |
| 197 | + | REIMBURSEMENT RATE F OR NONPARTICIPATING PROVIDERS WHO DELIVER 4 | |
| 198 | + | SERVICES UNDER PARAGRAPH (2) OF THIS SUBSECTION . 5 | |
| 196 | 199 | ||
| 197 | - | (i) have a system in place that documents all requests to obtain a 2 | |
| 198 | - | referral to receive a covered service from a specialist or nonphysician specialist who is not 3 | |
| 199 | - | part of the carrier’s provider panel; 4 | |
| 200 | + | (II) THE MARYLAND HEALTH CARE COMMISSION SHALL HOLD 6 | |
| 201 | + | PUBLIC MEETINGS WITH CARRIERS, MENTAL HEALTH AND SU BSTANCE USE 7 | |
| 202 | + | DISORDER PROVIDERS , CONSUMERS OF MENTAL HEALTH AND SUBSTANCE USE 8 | |
| 203 | + | DISORDER SERVICES , AND OTHER INTERESTED PARTIES TO DETERMINE THE 9 | |
| 204 | + | REIMBURSEMENT FO RMULA. 10 | |
| 200 | 205 | ||
| 201 | - | | |
| 202 | - | ||
| 206 | + | SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 11 | |
| 207 | + | as follows: 12 | |
| 203 | 208 | ||
| 204 | - | (iii) provide the information documented under item (i) of this 7 | |
| 205 | - | paragraph to the Commissioner on request. 8 | |
| 209 | + | Chapter 271 of the Acts of 2022 13 | |
| 206 | 210 | ||
| 207 | - | | |
| 208 | - | ||
| 209 | - | ||
| 210 | - | ||
| 211 | + | SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect July 14 | |
| 212 | + | 1, 2022. [It shall remain effective for a period of 3 years and, at the end of June 30, 2025, 15 | |
| 213 | + | this Act, with no further action required by the General Assembly, shall be abrogated and 16 | |
| 214 | + | of no further force and effect.] 17 | |
| 211 | 215 | ||
| 212 | - | (2) A carrier shall ensure that services received in accordance with 13 | |
| 213 | - | subsection (d) of this section for mental health or substance use disorders are provided FOR 14 | |
| 214 | - | THE DURATION OF THE TREATMENT PLAN at no greater cost to the covered individual 15 | |
| 215 | - | than if the covered benefit were provided by a provider on the carrier’s provider panel. 16 | |
| 216 | + | Chapter 272 of the Acts of 2022 18 | |
| 216 | 217 | ||
| 217 | - | (3) (I) SUBJECT TO SUBPARAGRA PH (II) OF THIS PARAGRAPH , AND 17 | |
| 218 | - | NOT LATER THAN JANUARY 1, 2026, THE MARYLAND HEALTH CARE COMMISSION 18 | |
| 219 | - | SHALL ESTABLISH A RE IMBURSEMENT FORMULA TO DETERMINE THE 19 | |
| 220 | - | REIMBURSEMENT RATE F OR NONPARTICIPATING PROVIDERS WHO DELIVE R 20 | |
| 221 | - | SERVICES UNDER PARAG RAPH (2) OF THIS SUBSECTION . 21 | |
| 218 | + | SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect July 19 | |
| 219 | + | 1, 2022. [It shall remain effective for a period of 3 years and, at the end of June 30, 2025, 20 | |
| 220 | + | this Act, with no further action required by the General Assembly, shall be abrogated and 21 | |
| 221 | + | of no further force and effect.] 22 | |
| 222 | 222 | ||
| 223 | - | (II) THE MARYLAND HEALTH CARE COMMISSION SHALL HOLD 22 | |
| 224 | - | PUBLIC MEETINGS WITH CARRIERS, MENTAL HEALTH AND SU BSTANCE USE 23 | |
| 225 | - | DISORDER PROVIDERS , CONSUMERS OF MENTAL HEALTH AND SUBSTANCE USE 24 | |
| 226 | - | DISORDER SERVICES , AND OTHER INTERESTED PARTIES TO DETERMINE THE 25 | |
| 227 | - | REIMBURSEMENT FORMUL A. 26 | |
| 223 | + | SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall 23 | |
| 224 | + | apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 24 | |
| 225 | + | State on or after January 1, 2026. 25 | |
| 228 | 226 | ||
| 229 | - | SECTION | |
| 230 | - | ||
| 227 | + | SECTION 4. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 26 | |
| 228 | + | effect January 1, 2026. 27 | |
| 231 | 229 | ||
| 232 | - | Chapter 271 of the Acts of 2022 29 | |
| 233 | - | ||
| 234 | - | SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect July 30 | |
| 235 | - | 1, 2022. [It shall remain effective for a period of 3 years and, at the end of June 30, 2025, 31 | |
| 236 | - | this Act, with no further action required by the General Assembly, shall be abrogated and 32 | |
| 237 | - | of no further force and effect.] 33 | |
| 238 | - | ||
| 239 | - | Chapter 272 of the Acts of 2022 34 | |
| 240 | - | 6 HOUSE BILL 11 | |
| 241 | - | ||
| 242 | - | ||
| 243 | - | SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect July 1 | |
| 244 | - | 1, 2022. [It shall remain effective for a period of 3 years and, at the end of June 30, 2025, 2 | |
| 245 | - | this Act, with no further action required by the General Assembly, shall be abrogated and 3 | |
| 246 | - | of no further force and effect.] 4 | |
| 247 | - | ||
| 248 | - | SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall 5 | |
| 249 | - | apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 6 | |
| 250 | - | State on or after January 1, 2026. 7 | |
| 251 | - | ||
| 252 | - | SECTION 4. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall take 8 | |
| 253 | - | effect January 1, 2026. 9 | |
| 254 | - | ||
| 255 | - | SECTION 5. AND BE IT FURTHER ENACTED, That, except as provided in Section 10 | |
| 256 | - | 4 of this Act, this Act shall take effect June 1, 2025. 11 | |
| 257 | - | ||
| 258 | - | ||
| 259 | - | ||
| 260 | - | ||
| 261 | - | Approved: | |
| 262 | - | ________________________________________________________________________________ | |
| 263 | - | Governor. | |
| 264 | - | ________________________________________________________________________________ | |
| 265 | - | Speaker of the House of Delegates. | |
| 266 | - | ________________________________________________________________________________ | |
| 267 | - | President of the Senate. | |
| 230 | + | SECTION 5. AND BE IT FURTHER ENACTED, That, except as provided in Section 28 | |
| 231 | + | 4 of this Act, this Act shall take effect June 1, 2025. 29 |