EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1104*
HOUSE BILL 1104
J1 5lr0253
By: Chair, Health and Government Operations Committee (By Request –
Departmental – Health)
Introduced and read first time: February 5, 2025
Assigned to: Health and Government Operations and Appropriations
A BILL ENTITLED
AN ACT concerning 1
Maryland Department of Health – AHEAD Model Implementation – Electronic 2
Health Care Transactions and Population Health Improvement Fund 3
FOR the purpose of clarifying that electronic health care transactions information may be 4
used to support the participation of the State in the States Advancing All–Payer 5
Health Equity Approaches and Development (AHEAD) Model and any successor 6
models; establishing the Population Health Improvement Fund as a special, 7
nonlapsing fund to invest in population health improvements to support the 8
statewide population health targets under the AHEAD Model and any successor 9
models; requiring that interest earnings of the Fund be credited to the Fund; 10
authorizing the Health Services Cost Review Commission to assess a certain amount 11
in hospital rates to be credited to the Fund; and generally relating to the 12
implementation of the AHEAD Model. 13
BY repealing and reenacting, with amendments, 14
Article – Health – General 15
Section 4–302.3(f)(3)(i), (h)(1), and (j)(3) 16
Annotated Code of Maryland 17
(2023 Replacement Volume and 2024 Supplement) 18
BY adding to 19
Article – Health – General 20
Section 13–5501 and 13–5502 to be under the new subtitle “Subtitle 55. Population 21
Health Improvement Fund” 22
Annotated Code of Maryland 23
(2023 Replacement Volume and 2024 Supplement) 24
BY repealing and reenacting, without amendments, 25
Article – State Finance and Procurement 26
Section 6–226(a)(2)(i) 27 2 HOUSE BILL 1104
Annotated Code of Maryland 1
(2021 Replacement Volume and 2024 Supplement) 2
BY repealing and reenacting, with amendments, 3
Article – State Finance and Procurement 4
Section 6–226(a)(2)(ii)204. and 205. 5
Annotated Code of Maryland 6
(2021 Replacement Volume and 2024 Supplement) 7
BY adding to 8
Article – State Finance and Procurement 9
Section 6–226(a)(2)(ii)206. 10
Annotated Code of Maryland 11
(2021 Replacement Volume and 2024 Supplement) 12
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 13
That the Laws of Maryland read as follows: 14
Article – Health – General 15
4–302.3. 16
(f) (3) (i) If approved by the Maryland Health Care Commission, the 17
information submitted under paragraph (1) of this subsection may be combined with other 18
data maintained by the State–designated health information exchange to facilitate: 19
1. A State health improvement program; 20
2. Mitigation of a public health emergency; [and] 21
3. Improvement of patient safety; AND 22
4. THE PARTICIPATION OF THE STATE IN THE CENTER 23
FOR MEDICARE AND MEDICAID INNOVATION’S STATES ADVANCING ALL–PAYER 24
HEALTH EQUITY APPROACHES AND DEVELOPMENT (AHEAD) MODEL AND ANY 25
SUCCESSOR MODELS . 26
(h) (1) An electronic health network shall provide electronic health care 27
transactions to the State–designated health information exchange for the following public 28
health and clinical purposes: 29
(i) A State health improvement program; 30
(ii) Mitigation of a public health emergency; [and] 31
(iii) Improvement of patient safety; AND 32 HOUSE BILL 1104 3
(IV) THE PARTICIPATION OF THE STATE IN THE CENTER FOR 1
MEDICARE AND MEDICAID INNOVATION’S STATES ADVANCING ALL–PAYER 2
HEALTH EQUITY APPROACHES AND DEVELOPMENT (AHEAD) MODEL AND ANY 3
SUCCESSOR MODELS . 4
(j) (3) Regulations adopted under paragraph (1) of this subsection [shall]: 5
(i) [Limit] SHALL LIMIT redisclosure of financial information, 6
including billed or paid amounts available in electronic claims transactions; 7
(II) MAY NOT RESTRICT THE STATE’S USE OF FINANCIAL 8
INFORMATION , INCLUDING BILLED OR PAID AMOUNTS AVAILAB LE IN ELECTRONIC 9
CLAIMS TRANSACTIONS , FOR PUBLIC HEALTH PU RPOSES RELATED TO TH E 10
PARTICIPATION OF THE STATE IN THE CENTER FOR MEDICARE AND MEDICAID 11
INNOVATION’S STATES ADVANCING ALL–PAYER HEALTH EQUITY APPROACHES 12
AND DEVELOPMENT (AHEAD) MODEL AND ANY SUCCESS OR MODELS; 13
[(ii)] (III) [Restrict] SHALL RESTRICT data of patients who have 14
opted out of records sharing through the State–designated health information exchange or 15
a health information exchange authorized by the Maryland Health Care Commission; 16
[(iii)] (IV) [Restrict] SHALL RESTRICT data from health care 17
providers that possess sensitive health care information; and 18
[(iv)] (V) [Restrict] SHALL RESTRICT data of patients who have 19
obtained legally protected health care. 20
SUBTITLE 55. POPULATION HEALTH IMPROVEMENT FUND. 21
13–5501. 22
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 23
INDICATED. 24
(B) “AHEAD MODEL” MEANS THE STATES ADVANCING ALL–PAYER 25
HEALTH EQUITY APPROACHES AND DEVELOPMENT MODEL ADMINISTERED BY THE 26
CENTER FOR MEDICARE AND MEDICAID INNOVATION. 27
(C) “FUND” MEANS THE POPULATION HEALTH IMPROVEMENT FUND. 28
(D) “STATEWIDE HEALTH EQUI TY PLAN” MEANS THE EQUITY PLA N 29
REQUIRED UNDER THE AHEAD MODEL STATE AGREEMENT WITH THE CENTER 30
FOR MEDICARE AND MEDICAID SERVICES. 31 4 HOUSE BILL 1104
13–5502. 1
(A) THERE IS A POPULATION HEALTH IMPROVEMENT FUND. 2
(B) THE PURPOSE OF THE FUND IS TO INVEST IN POPULATION HEALTH 3
IMPROVEMENTS TO SUPP ORT THE STATEWIDE PO PULATION HEALTH TARGETS 4
UNDER THE AHEAD MODEL AND ANY SUCCESS OR MODELS. 5
(C) THE DEPARTMENT AND THE HEALTH SERVICES COST REVIEW 6
COMMISSION JOINTLY SH ALL ADMINISTER THE FUND. 7
(D) (1) THE FUND IS A SPECIAL , NONLAPSING FUND THAT IS NOT 8
SUBJECT TO § 7–302 OF THE STATE FINANCE AND PROCUREMENT ARTICLE. 9
(2) THE STATE TREASURER SHALL HOLD THE FUND SEPARATELY , 10
AND THE COMPTROLLER SHALL ACC OUNT FOR THE FUND. 11
(E) THE FUND CONSISTS OF : 12
(1) THE REVENUES FROM THE UNIFORM, BROAD–BASED 13
ASSESSMENT MADE UNDE R SUBSECTION (K) OF THIS SECTION; 14
(2) MONEY APPROPRIATED IN THE STATE BUDGET TO THE FUND; 15
(3) INTEREST EARNINGS ; AND 16
(4) ANY OTHER MONEY FROM ANY OTHER SOURCE ACC EPTED FOR 17
THE BENEFIT OF THE FUND. 18
(F) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , THE FUND 19
MAY BE USED ONLY FOR EXPENS ES ASSOCIATED WITH S TATEWIDE POPULATION 20
HEALTH IMPROVEMENT I NITIATIVES IN ALIGNM ENT WITH THE STATEWI DE HEALTH 21
EQUITY PLAN AS DIREC TED BY THE SECRETARY. 22
(2) ACTIVITIES PAID FOR B Y THE FUND MUST SUPPORT THE GOAL OF 23
MEETING THE STATEWI DE POPULATION HEALTH TARGETS OUTLINED IN THE 24
AHEAD MODEL STATE AGREEMENT WITH THE CENTER FOR MEDICARE AND 25
MEDICAID SERVICES AND HAVE AT LEAST ONE OF THE FOL LOWING FUNCTIONS : 26
(I) REDUCING RATES OF COM MON PREVENTABLE HEAL TH 27
CONDITIONS; 28
HOUSE BILL 1104 5
(II) ADDRESSING HEALTH –RELATED SOCIAL NEEDS ; OR 1
(III) REDUCING OR ELIMINATI NG HEALTH DISPARITIE S. 2
(G) (1) THE STATE TREASURER SHALL INVES T THE MONEY OF THE FUND 3
IN THE SAME MANNER A S OTHER STATE MONEY MAY BE IN VESTED. 4
(2) ANY INTEREST EARNINGS OF THE FUND SHALL BE CREDITE D TO 5
THE FUND. 6
(H) EXPENDITURES FROM THE FUND MAY BE MADE ONLY IN ACCORDANCE 7
WITH THE STATE BUDGET . 8
(I) MONEY EXPENDED FROM T HE FUND IS SUPPLEMENTAL TO AND IS NOT 9
INTENDED TO TAKE THE PLACE OF FUNDING THA T WOULD OTHERWISE BE 10
APPROPRIATED FOR THE MARYLAND MEDICAL ASSISTANCE PROGRAM. 11
(J) THE FUND IS SUBJECT TO AU DIT BY THE OFFICE OF LEGISLATIVE 12
AUDITS AS PROVIDED IN § 2–1220 OF THE STATE GOVERNMENT ARTICLE. 13
(K) (1) EACH YEAR, THE HEALTH SERVICES COST REVIEW COMMISSION 14
MAY ASSESS A UNIFORM, BROAD–BASED, AND REASONABLE AMOUN T IN HOSPITAL 15
RATES TO BE CREDITED TO THE FUND. 16
(2) FUNDS GENERATED FROM THE ASSESSMENT UNDER PARAGRAPH 17
(1) OF THIS SUBSECTION M AY BE USED ONLY FOR THE EXPENSES DESCRIB ED IN 18
SUBSECTION (F) OF THIS SECTION. 19
Article – State Finance and Procurement 20
6–226. 21
(a) (2) (i) 1. This subparagraph does not apply in fiscal years 2024 22
through 2028. 23
2. Notwithstanding any other provision of law, and unless 24
inconsistent with a federal law, grant agreement, or other federal requirement or with the 25
terms of a gift or settlement agreement, net interest on all State money allocated by the 26
State Treasurer under this section to special funds or accounts, and otherwise entitled to 27
receive interest earnings, as accounted for by the Comptroller, shall accrue to the General 28
Fund of the State. 29
(ii) The provisions of subparagraph (i) of this paragraph do not apply 30
to the following funds: 31
6 HOUSE BILL 1104
204. the Victims of Domestic Violence Program Grant Fund; 1
[and] 2
205. the Proposed Programs Collaborative Grant Fund; AND 3
206. THE POPULATION HEALTH IMPROVEMENT FUND. 4
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 5
1, 2025. 6