EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb1351*
HOUSE BILL 1351
J5 5lr3352
By: Delegate Ghrist
Introduced and read first time: February 7, 2025
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Provider Panels – Credentialing for Behavioral Health Care 2
Professionals 3
FOR the purpose of altering the period of time in which certain carriers are required to 4
accept or deny certain social workers, counselors, therapists, and psychology 5
associates for participation on the carrier’s provider panel; and generally relating to 6
and the credentialing of behavioral health care professionals for health insurance 7
provider panels. 8
BY repealing and reenacting, with amendments, 9
Article – Insurance 10
Section 15–112(g) 11
Annotated Code of Maryland 12
(2017 Replacement Volume and 2024 Supplement) 13
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
That the Laws of Maryland read as follows: 15
Article – Insurance 16
15–112. 17
(g) (1) A provider that seeks to participate on a provider panel of a carrier shall 18
submit an application to the carrier. 19
(2) (i) Subject to subparagraph (ii) of this paragraph and paragraph (3) 20
of this subsection, the carrier, after reviewing the application, shall accept or reject the 21
provider for participation on the carrier’s provider panel. 22
(ii) A carrier may not reject a provider who provides 23
community–based health services for a program accredited under COMAR 10.63.02 for 24 2 HOUSE BILL 1351
participation on the carrier’s provider panel because the provider practices within the scope 1
of the provider’s license and is: 2
1. a licensed graduate social worker or a licensed master 3
social worker, as those terms are defined in § 19–101 of the Health Occupations Article; 4
2. a licensed graduate alcohol and drug counselor, a licensed 5
graduate marriage and family therapist, a licensed graduate professional art therapist, or 6
a licensed graduate professional counselor, as those terms are defined in § 17–101 of the 7
Health Occupations Article; or 8
3. a registered psychology associate, as defined in § 18–101 9
of the Health Occupations Article. 10
(iii) If the carrier rejects the provider for participation on the carrier’s 11
provider panel, the carrier shall send to the provider at the address listed in the application 12
written notice of the rejection. 13
(3) (i) [Subject] EXCEPT AS PROVIDED IN SUBPARAGRAPH (IV) OF 14
THIS PARAGRAPH AND S UBJECT to paragraph (4) of this subsection, within 30 days after 15
the date a carrier receives a completed application, the carrier shall send to the provider at 16
the address listed in the application written notice of: 17
1. the carrier’s intent to continue to process the provider’s 18
application to obtain necessary credentialing information; or 19
2. the carrier’s rejection of the provider for participation on 20
the carrier’s provider panel. 21
(ii) The failure of a carrier to provide the notice required under 22
subparagraph (i) of this paragraph is a violation of this article and the carrier is subject to 23
the penalties provided by § 4–113(d) of this article. 24
(iii) Except as provided in subsection (v) of this section, if, under 25
subparagraph (i)1 of this paragraph, a carrier provides notice to the provider of its intent 26
to continue to process the provider’s application to obtain necessary credentialing 27
information, the carrier, within 120 days after the date the notice is provided, shall: 28
1. accept or reject the provider for participation on the 29
carrier’s provider panel; and 30
2. send written notice of the acceptance or rejection to the 31
provider at the address listed in the application. 32
(IV) FOR A PROVIDER DESCRI BED IN PARAGRAPH (2)(II) OF THIS 33
SUBSECTION, A LICENSED CERTIFIED SOCIAL WORKER –CLINICAL, OR A LICENSED 34 HOUSE BILL 1351 3
CLINICAL PROFESSIONA L COUNSELOR , WITHIN 30 DAYS AFTER THE DATE A 1
CARRIER RECEIVES A C OMPLETED APPLICATION , THE CARRIER SHALL : 2
1. ACCEPT OR REJECT THE PROVIDER FOR 3
PARTICIPATION ON THE CARRIER’S PROVIDER PANEL ; AND 4
2. SEND WRITTEN NOTICE OF THE ACCEPTANCE OR 5
REJECTION TO THE PRO VIDER AT THE ADDRESS LISTED IN THE APPLIC ATION. 6
[(iv)] (V) The failure of a carrier to provide the notice required 7
under subparagraph (iii)2 OR (IV) of this paragraph is a violation of this article and the 8
carrier is subject to the provisions of and penalties provided by §§ 4–113 and 4–114 of this 9
article. 10
(4) (i) 1. Except as provided in subsubparagraph 4 of this 11
subparagraph, a carrier that receives a complete application shall notify the provider that 12
the application is complete. 13
2. If a carrier does not accept applications through the online 14
credentialing system, notice shall be given to the provider at the address listed in the 15
application within 10 days after the date the application is received. 16
3. If a carrier accepts applications through the online 17
credentialing system, the notice from the online credentialing system to the provider that 18
the carrier has received the provider’s application shall be considered notice that the 19
application is complete. 20
4. This subparagraph does not apply to a carrier that 21
arranges a dental provider panel until the Commissioner certifies that the online 22
credentialing system is capable of accepting the uniform credentialing form designated by 23
the Commissioner for dental provider panels. 24
(ii) 1. A carrier that receives an incomplete application shall 25
return the application to the provider at the address listed in the application within 10 days 26
after the date the application is received. 27
2. The carrier shall indicate to the provider what information 28
is needed to make the application complete. 29
3. The provider may return the completed application to the 30
carrier. 31
4. After the carrier receives the completed application, the 32
carrier is subject to the time periods established in paragraph (3) of this subsection. 33
4 HOUSE BILL 1351
(5) A carrier may charge a reasonable fee for an application submitted to 1
the carrier under this section. 2
SECTION 2. AND BE IT FUR THER ENACTED, That this Act shall take effect 3
October 1, 2025. 4