| Old | New | Differences | |
|---|---|---|---|
| 1 | 1 | ||
| 2 | 2 | ||
| 3 | 3 | EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G 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 | *hb1315* | |
| 9 | 6 | ||
| 10 | 7 | HOUSE BILL 1315 | |
| 11 | 8 | J5, J1 5lr2486 | |
| 12 | 9 | ||
| 13 | 10 | By: Delegates Guzzone, Pena–Melnyk, Barnes, Crutchfield, Cullison, Embry, Fair, | |
| 14 | 11 | Forbes, Harris, Hill, Kaiser, R. Lewis, Lopez, Martinez, Palakovich Carr, | |
| 15 | 12 | Pruski, Ruff, Schindler, Smith, Stewart, Terrasa, Williams, and Woorman | |
| 16 | - | Woorman, Alston, Bagnall, Bhandari, S. Johnson, Kerr, Rosenberg, Ross, | |
| 17 | - | Taveras, White Holland, and Woods | |
| 18 | 13 | Introduced and read first time: February 7, 2025 | |
| 19 | 14 | Assigned to: Health and Government Operations | |
| 20 | - | Committee Report: Favorable with amendments | |
| 21 | - | House action: Adopted | |
| 22 | - | Read second time: March 6, 2025 | |
| 23 | 15 | ||
| 24 | - | ||
| 16 | + | A BILL ENTITLED | |
| 25 | 17 | ||
| 26 | 18 | AN ACT concerning 1 | |
| 27 | 19 | ||
| 28 | - | Health Insurance – Vaccinations by Pharmacists and Health Insurance 2 | |
| 29 | - | Coverage for Child Wellness Services – Immunizations 3 | |
| 20 | + | Health Insurance – Coverage for Child Wellness Services – Immunizations 2 | |
| 30 | 21 | ||
| 31 | - | FOR the purpose of altering the vaccinations that a pharmacist may administer, subject to 4 | |
| 32 | - | certain requirements, to an individual of at least a certain age; altering the 5 | |
| 33 | - | vaccinations included in the minimum package of child wellness services for which 6 | |
| 34 | - | certain health insurers and nonprofit health service plans are required to provide 7 | |
| 35 | - | coverage; and generally relating to health insurance coverage for child wellness 8 | |
| 36 | - | services immunizations. 9 | |
| 22 | + | FOR the purpose of altering the vaccinations included in the minimum package of child 3 | |
| 23 | + | wellness services for which certain health insurers and nonprofit health service 4 | |
| 24 | + | plans are required to provide coverage; and generally relating to health insurance 5 | |
| 25 | + | coverage for child wellness services. 6 | |
| 37 | 26 | ||
| 38 | - | BY repealing and reenacting, | |
| 39 | - | Article – | |
| 40 | - | ||
| 41 | - | Annotated Code of Maryland | |
| 42 | - | ( | |
| 27 | + | BY repealing and reenacting, without amendments, 7 | |
| 28 | + | Article – Insurance 8 | |
| 29 | + | Section 15–817(a), (b), and (f) 9 | |
| 30 | + | Annotated Code of Maryland 10 | |
| 31 | + | (2017 Replacement Volume and 2024 Supplement) 11 | |
| 43 | 32 | ||
| 44 | - | BY repealing and reenacting, without amendments, 15 | |
| 45 | - | Article – Insurance 16 | |
| 46 | - | Section 15–817(a), (b), and (f) 17 | |
| 47 | - | Annotated Code of Maryland 18 | |
| 48 | - | (2017 Replacement Volume and 2024 Supplement) 19 2 HOUSE BILL 1315 | |
| 33 | + | BY repealing and reenacting, with amendments, 12 | |
| 34 | + | Article – Insurance 13 | |
| 35 | + | Section 15–817(c) 14 | |
| 36 | + | Annotated Code of Maryland 15 | |
| 37 | + | (2017 Replacement Volume and 2024 Supplement) 16 | |
| 38 | + | ||
| 39 | + | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17 | |
| 40 | + | That the Laws of Maryland read as follows: 18 | |
| 41 | + | ||
| 42 | + | Article – Insurance 19 | |
| 43 | + | ||
| 44 | + | 15–817. 20 | |
| 45 | + | ||
| 46 | + | (a) In this section, “child wellness services” means preventive activities designed 21 | |
| 47 | + | to protect children from morbidity and mortality and promote child development. 22 | |
| 48 | + | 2 HOUSE BILL 1315 | |
| 49 | 49 | ||
| 50 | 50 | ||
| 51 | + | (b) This section applies to each individual hospital or major medical insurance 1 | |
| 52 | + | policy, group or blanket health insurance policy, and nonprofit health service plan that: 2 | |
| 51 | 53 | ||
| 52 | - | BY repealing and reenacting, with amendments, 1 | |
| 53 | - | Article – Insurance 2 | |
| 54 | - | Section 15–817(c) 3 | |
| 55 | - | Annotated Code of Maryland 4 | |
| 56 | - | (2017 Replacement Volume and 2024 Supplement) 5 | |
| 54 | + | (1) is delivered or issued for delivery in the State; 3 | |
| 57 | 55 | ||
| 58 | - | BY adding to 6 | |
| 59 | - | Article – Insurance 7 | |
| 60 | - | Section 15–817(g) 8 | |
| 61 | - | Annotated Code of Maryland 9 | |
| 62 | - | (2017 Replacement Volume and 2024 Supplement) 10 | |
| 56 | + | (2) is written on an expense–incurred basis; and 4 | |
| 63 | 57 | ||
| 64 | - | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 11 | |
| 65 | - | That the Laws of Maryland read as follows: 12 | |
| 58 | + | (3) provides coverage for a family member of the insured. 5 | |
| 66 | 59 | ||
| 67 | - | Article – Health Occupations 13 | |
| 60 | + | (c) (1) A policy or plan subject to this section shall include under the family 6 | |
| 61 | + | member coverage a minimum package of child wellness services that are consistent with: 7 | |
| 68 | 62 | ||
| 69 | - | ||
| 63 | + | (i) public health policy; 8 | |
| 70 | 64 | ||
| 71 | - | (a) (1) Subject to paragraph (4) of this subsection, a pharmacist may order and 15 | |
| 72 | - | administer a vaccination to an individual who is at least 3 years old if: 16 | |
| 65 | + | (ii) professional standards; and 9 | |
| 73 | 66 | ||
| 74 | - | ( | |
| 67 | + | (iii) scientific evidence of effectiveness. 10 | |
| 75 | 68 | ||
| 76 | - | | |
| 69 | + | (2) The minimum package of child wellness services shall cover at least: 11 | |
| 77 | 70 | ||
| 78 | - | 2. A COVID–19 vaccine; or 19 | |
| 71 | + | (i) all visits for and costs of childhood and adolescent 12 | |
| 72 | + | immunizations: 13 | |
| 79 | 73 | ||
| 80 | - | 3. Used in response to a public health emergency; 20 | |
| 74 | + | 1. recommended by the Advisory Committee on 14 | |
| 75 | + | Immunization Practices of the Centers for Disease Control and Prevention; OR 15 | |
| 81 | 76 | ||
| 82 | - | (ii) The pharmacist has completed a practical training program of at 21 | |
| 83 | - | least 20 hours that is approved by the Accreditation Council for Pharmacy Education and 22 | |
| 84 | - | includes: 23 | |
| 77 | + | 2. RECOMMENDED BY THE AMERICAN ACADEMY OF 16 | |
| 78 | + | PEDIATRICS IN ITS CHILD AND ADOLESCENT IMMUNIZATION SCHEDULE BY AGE; 17 | |
| 85 | 79 | ||
| 86 | - | 1. Hands–on injection techniques; 24 | |
| 80 | + | (ii) visits for the collection of adequate samples, the first of which is 18 | |
| 81 | + | to be collected before 2 weeks of age, for hereditary and metabolic newborn screening and 19 | |
| 82 | + | follow–up between birth and 4 weeks of age; 20 | |
| 87 | 83 | ||
| 88 | - | | |
| 89 | - | ||
| 84 | + | (iii) universal hearing screening of newborns provided by a hospital 21 | |
| 85 | + | before discharge; 22 | |
| 90 | 86 | ||
| 91 | - | 3. The recognition and treatment of emergency reactions to 27 | |
| 92 | - | vaccines; 28 | |
| 87 | + | (iv) all visits for and costs of age–appropriate screening tests for 23 | |
| 88 | + | tuberculosis, anemia, lead toxicity, hearing, and vision as determined by the American 24 | |
| 89 | + | Academy of Pediatrics; 25 | |
| 93 | 90 | ||
| 94 | - | (iii) The pharmacist has a current certificate in basic 29 | |
| 95 | - | cardiopulmonary resuscitation; 30 | |
| 91 | + | (v) all visits for obesity evaluation and management; 26 | |
| 92 | + | ||
| 93 | + | (vi) all visits for and costs of developmental screening as 27 | |
| 94 | + | recommended by the American Academy of Pediatrics; 28 | |
| 96 | 95 | HOUSE BILL 1315 3 | |
| 97 | 96 | ||
| 98 | 97 | ||
| 99 | - | (iv) The pharmacist has completed a minimum of 2 hours of 1 | |
| 100 | - | continuing pharmaceutical education related to immunizations that is approved by the 2 | |
| 101 | - | Accreditation Council for Pharmacy Education as part of the license renewal requirements 3 | |
| 102 | - | under § 12–309 of this title; 4 | |
| 98 | + | (vii) a physical examination, developmental assessment, and 1 | |
| 99 | + | parental anticipatory guidance services at each of the visits required under items (i), (ii), 2 | |
| 100 | + | (iv), (v), and (vi) of this paragraph; and 3 | |
| 103 | 101 | ||
| 104 | - | (v) The pharmacist complies with the record–keeping and reporting 5 | |
| 105 | - | requirements in paragraph (5) of this subsection and any corresponding regulations 6 | |
| 106 | - | adopted by the Board; and 7 | |
| 102 | + | (viii) any laboratory tests considered necessary by the physician as 4 | |
| 103 | + | indicated by the services provided under items (i), (ii), (iv), (v), (vi), or (vii) of this paragraph. 5 | |
| 107 | 104 | ||
| 108 | - | (vi) If the vaccination is administered to an individual under the age 8 | |
| 109 | - | of 18 years, the pharmacist informs the child vaccination patient and adult caregiver who 9 | |
| 110 | - | is accompanying the child of the importance of well–child visits with a pediatric primary 10 | |
| 111 | - | care provider and refers the patient to a pediatric primary care provider when appropriate. 11 | |
| 105 | + | (f) (1) A policy or plan subject to this section may not impose a deductible on 6 | |
| 106 | + | the coverage required under this section. 7 | |
| 112 | 107 | ||
| 113 | - | (2) | |
| 114 | - | ||
| 115 | - | ||
| 108 | + | (2) Each health insurance policy and certificate shall contain a notice of the 8 | |
| 109 | + | prohibition established by paragraph (1) of this subsection in a form approved by the 9 | |
| 110 | + | Commissioner. 10 | |
| 116 | 111 | ||
| 117 | - | (i) Recommended by the Centers for Disease Control and 15 | |
| 118 | - | Prevention’s Advisory Committee on Immunization Practices; or 16 | |
| 112 | + | SECTION 2. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall 11 | |
| 113 | + | apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 12 | |
| 114 | + | State on or after January 1, 2026. 13 | |
| 119 | 115 | ||
| 120 | - | (ii) Approved or authorized by the U.S. Food and Drug 17 | |
| 121 | - | Administration. 18 | |
| 122 | - | ||
| 123 | - | (3) Subject to paragraph (4) of this subsection, a pharmacist who has met 19 | |
| 124 | - | the requirement of paragraph (1)(ii), (iii), and (iv) of this subsection may administer to an 20 | |
| 125 | - | adult a vaccination that is recommended in the Centers for Disease Control and 21 | |
| 126 | - | Prevention’s Health Information for International Travel. 22 | |
| 127 | - | ||
| 128 | - | (4) (I) A pharmacist shall administer a vaccination under paragraph 23 | |
| 129 | - | (1), (2), or (3) of this subsection under a written protocol that: 24 | |
| 130 | - | ||
| 131 | - | [(i)] 1. Is vaccine specific; and 25 | |
| 132 | - | ||
| 133 | - | [(ii)] 2. Meets criteria established by the Department, in 26 | |
| 134 | - | consultation with the Board, the Board of Physicians, and the Board of Nursing, in 27 | |
| 135 | - | regulation. 28 | |
| 136 | - | ||
| 137 | - | (II) THE RECOMMENDATIONS O F THE CENTERS FOR DISEASE 29 | |
| 138 | - | CONTROL AND PREVENTION’S ADVISORY COMMITTEE ON IMMUNIZATION 30 | |
| 139 | - | PRACTICES CITED IN TH IS SECTION REFER TO FEDERAL STATUTES , RULES, AND 31 | |
| 140 | - | GUIDANCE IN EFFECT : 32 | |
| 141 | - | ||
| 142 | - | 1. ON DECEMBER 31, 2024; OR 33 | |
| 143 | - | 4 HOUSE BILL 1315 | |
| 144 | - | ||
| 145 | - | ||
| 146 | - | 2. AT A LATER DATE TO AC COUNT FOR ANY NEW 1 | |
| 147 | - | VACCINES RECOMMENDED BY THE CENTERS FOR DISEASE CONTROL AND 2 | |
| 148 | - | PREVENTION’S ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES AFTER 3 | |
| 149 | - | DECEMBER 31, 2024. 4 | |
| 150 | - | ||
| 151 | - | (5) A pharmacist shall: 5 | |
| 152 | - | ||
| 153 | - | (i) Report all vaccinations administered by the pharmacist to the 6 | |
| 154 | - | ImmuNet Program established under § 18–109 of the Health – General Article; 7 | |
| 155 | - | ||
| 156 | - | (ii) If the vaccination has been administered in accordance with a 8 | |
| 157 | - | prescription, document at least one effort to inform the individual’s authorized prescriber 9 | |
| 158 | - | that the vaccination has been administered; and 10 | |
| 159 | - | ||
| 160 | - | (iii) Except for an influenza vaccination administered under 11 | |
| 161 | - | paragraph (1) of this subsection, if the authorized prescriber is not the individual’s primary 12 | |
| 162 | - | care provider or if the vaccination has not been administered in accordance with a 13 | |
| 163 | - | prescription, document at least one effort to inform the individual’s primary care provider 14 | |
| 164 | - | or other usual source of care that the vaccination has been administered. 15 | |
| 165 | - | ||
| 166 | - | (b) The Board shall: 16 | |
| 167 | - | ||
| 168 | - | (1) Set reasonable fees for the administration of vaccinations under this 17 | |
| 169 | - | section; and 18 | |
| 170 | - | ||
| 171 | - | (2) Adopt regulations that require a pharmacist to submit a registration 19 | |
| 172 | - | form to the Board that includes verification that the pharmacist: 20 | |
| 173 | - | ||
| 174 | - | (i) Has successfully completed a certification course approved by the 21 | |
| 175 | - | Board that included instruction in the guidelines and recommendations of the Centers for 22 | |
| 176 | - | Disease Control and Prevention regarding vaccinations IN EFFECT ON DECEMBER 31, 23 | |
| 177 | - | 2024; and 24 | |
| 178 | - | ||
| 179 | - | (ii) Is certified in basic cardiopulmonary resuscitation and obtained 25 | |
| 180 | - | the certification through in–person classroom instruction. 26 | |
| 181 | - | ||
| 182 | - | Article – Insurance 27 | |
| 183 | - | ||
| 184 | - | 15–817. 28 | |
| 185 | - | ||
| 186 | - | (a) In this section, “child wellness services” means preventive activities designed 29 | |
| 187 | - | to protect children from morbidity and mortality and promote child development. 30 | |
| 188 | - | ||
| 189 | - | (b) This section applies to each individual hospital or major medical insurance 31 | |
| 190 | - | policy, group or blanket health insurance policy, and nonprofit health service plan that: 32 | |
| 191 | - | HOUSE BILL 1315 5 | |
| 192 | - | ||
| 193 | - | ||
| 194 | - | (1) is delivered or issued for delivery in the State; 1 | |
| 195 | - | ||
| 196 | - | (2) is written on an expense–incurred basis; and 2 | |
| 197 | - | ||
| 198 | - | (3) provides coverage for a family member of the insured. 3 | |
| 199 | - | ||
| 200 | - | (c) (1) A policy or plan subject to this section shall include under the family 4 | |
| 201 | - | member coverage a minimum package of child wellness services that are consistent with: 5 | |
| 202 | - | ||
| 203 | - | (i) public health policy; 6 | |
| 204 | - | ||
| 205 | - | (ii) professional standards; and 7 | |
| 206 | - | ||
| 207 | - | (iii) scientific evidence of effectiveness. 8 | |
| 208 | - | ||
| 209 | - | (2) The minimum package of child wellness services shall cover at least: 9 | |
| 210 | - | ||
| 211 | - | (i) all visits for and costs of childhood and adolescent 10 | |
| 212 | - | immunizations: 11 | |
| 213 | - | ||
| 214 | - | 1. recommended by the Advisory Committee on 12 | |
| 215 | - | Immunization Practices of the Centers for Disease Control and Prevention; OR 13 | |
| 216 | - | ||
| 217 | - | 2. RECOMMENDED BY THE AMERICAN ACADEMY OF 14 | |
| 218 | - | PEDIATRICS IN ITS CHILD AND ADOLESCENT IMMUNIZATION SCHEDULE BY AGE AS 15 | |
| 219 | - | OF DECEMBER 31, 2024; 16 | |
| 220 | - | ||
| 221 | - | (ii) visits for the collection of adequate samples, the first of which is 17 | |
| 222 | - | to be collected before 2 weeks of age, for hereditary and metabolic newborn screening and 18 | |
| 223 | - | follow–up between birth and 4 weeks of age; 19 | |
| 224 | - | ||
| 225 | - | (iii) universal hearing screening of newborns provided by a hospital 20 | |
| 226 | - | before discharge; 21 | |
| 227 | - | ||
| 228 | - | (iv) all visits for and costs of age–appropriate screening tests for 22 | |
| 229 | - | tuberculosis, anemia, lead toxicity, hearing, and vision as determined by the American 23 | |
| 230 | - | Academy of Pediatrics; 24 | |
| 231 | - | ||
| 232 | - | (v) all visits for obesity evaluation and management; 25 | |
| 233 | - | ||
| 234 | - | (vi) all visits for and costs of developmental screening as 26 | |
| 235 | - | recommended by the American Academy of Pediatrics; 27 | |
| 236 | - | ||
| 237 | - | (vii) a physical examination, developmental assessment, and 28 | |
| 238 | - | parental anticipatory guidance services at each of the visits required under items (i), (ii), 29 | |
| 239 | - | (iv), (v), and (vi) of this paragraph; and 30 6 HOUSE BILL 1315 | |
| 240 | - | ||
| 241 | - | ||
| 242 | - | ||
| 243 | - | (viii) any laboratory tests considered necessary by the physician as 1 | |
| 244 | - | indicated by the services provided under items (i), (ii), (iv), (v), (vi), or (vii) of this paragraph. 2 | |
| 245 | - | ||
| 246 | - | (f) (1) A policy or plan subject to this section may not impose a deductible on 3 | |
| 247 | - | the coverage required under this section. 4 | |
| 248 | - | ||
| 249 | - | (2) Each health insurance policy and certificate shall contain a notice of the 5 | |
| 250 | - | prohibition established by paragraph (1) of this subsection in a form approved by the 6 | |
| 251 | - | Commissioner. 7 | |
| 252 | - | ||
| 253 | - | (G) THE COMMISSIONER MAY ADOP T REGULATIONS NECESS ARY TO CARRY 8 | |
| 254 | - | OUT SUBPARAGRAPH (C)(2)(I) OF THIS SECTION , CONSISTENT WITH FEDE RAL 9 | |
| 255 | - | STATUTES, RULES, AND GUIDANCE IN EFFE CT: 10 | |
| 256 | - | ||
| 257 | - | (1) ON DECEMBER 31, 2024; OR 11 | |
| 258 | - | ||
| 259 | - | (2) AT A LATER DATE TO A CCOUNT FOR ANY NEW V ACCINES 12 | |
| 260 | - | RECOMMENDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION’S 13 | |
| 261 | - | ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES AFTER DECEMBER 31, 2024. 14 | |
| 262 | - | ||
| 263 | - | SECTION 2. AND BE IT FURTHER ENACTED, That Section 1 of this Act shall 15 | |
| 264 | - | apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 16 | |
| 265 | - | State on or after January 1, 2026. 17 | |
| 266 | - | ||
| 267 | - | SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 18 | |
| 268 | - | January 1, 2026 June 1, 2025. 19 | |
| 269 | - | ||
| 270 | - | ||
| 271 | - | ||
| 272 | - | ||
| 273 | - | Approved: | |
| 274 | - | ________________________________________________________________________________ | |
| 275 | - | Governor. | |
| 276 | - | ________________________________________________________________________________ | |
| 277 | - | Speaker of the House of Delegates. | |
| 278 | - | ________________________________________________________________________________ | |
| 279 | - | President of the Senate. | |
| 116 | + | SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 14 | |
| 117 | + | January 1, 2026. 15 |