Maryland 2025 Regular Session

Maryland House Bill HB1351 Compare Versions

Version 1 (Old)

Version 2 (New)

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	5		Underlining indicates amendments to bill.
6	6		Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7	7		amendment.
8		-	Italics indicate opposite chamber/conference committee amendments.
9	8		hb1351
10	9
11	10		HOUSE BILL 1351
12		-	J5 (5lr3352)
13		-	ENROLLED BILL
14		-	— Health and Government Operations/Finance —
15		-	Introduced by Delegate Ghrist Delegates Ghrist, Alston, Bagnall , Bhandari,
16		-	Chisholm, Cullison, Guzzone, Hill, Hutchinson, S. Johnson, Kaiser, Kerr,
17		-	Kipke, Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Ross,
	11	+	J5 5lr3352
	12	+	CF 5lr3641
	13	+	By: Delegate Ghrist Delegates Ghrist, Alston, Bagnall, Bhandari, Chisholm,
	14	+	Cullison, Guzzone, Hill, Hutchinson, S. Johnson, Kaiser, Kerr, Kipke,
	15	+	Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Ross,
18	16		Szeliga, Taveras, White Holland, Woods, and Woorman
19		-
20		-	Read and Examined by Proofreaders:
21		-
22		-	_______________________________________________
23		-	Proofreader.
24		-	_______________________________________________
25		-	Proofreader.
26		-
27		-	Sealed with the Great Seal and presented to the Governor, for his approval this
28		-
29		-	_______ day of _______________ at ________________________ o’clock, ________M.
30		-
31		-	______________________________________________
32		-	Speaker.
	17	+	Introduced and read first time: February 7, 2025
	18	+	Assigned to: Health and Government Operations
	19	+	Committee Report: Favorable with amendments
	20	+	House action: Adopted
	21	+	Read second time: March 6, 2025
33	22
34	23		CHAPTER ______
35	24
36	25		AN ACT concerning 1
37	26
38	27		Health Insurance – Provider Panels – Credentialing for Behavioral Health Care 2
39	28		Professionals 3
40	29
41		-	FOR the purpose of altering the providers of certain community–based health services that 4
42		-	a carrier is prohibited from rejecting for participation on the carrier’s provider panel; 5
43		-	altering the period of time in which certain carriers are required to accept or deny 6
44		-	certain social workers, counselors, therapists, and psychology associates for 7
45		-	participation on the carrier’s provider panel; and generally relating to and the 8
46		-	credentialing of behavioral health care professionals for health insurance provider 9
47		-	panels. 10
	30	+	FOR the purpose of altering the period of time in which certain carriers are required to 4
	31	+	accept or deny certain social workers, counselors, therapists, and psychology 5
	32	+	associates for participation on the carrier’s provider panel; and generally relating to 6
	33	+	and the credentialing of behavioral health care professionals for health insurance 7
	34	+	provider panels. 8
48	35
49		-	BY repealing and reenacting, with amendments, 11 2 HOUSE BILL 1351
	36	+	BY repealing and reenacting, with amendments, 9
	37	+	Article – Insurance 10
	38	+	Section 15–112(g) 11
	39	+	Annotated Code of Maryland 12
	40	+	(2017 Replacement Volume and 2024 Supplement) 13
	41	+
	42	+	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14
	43	+	That the Laws of Maryland read as follows: 15
	44	+
	45	+	Article – Insurance 16
	46	+
	47	+	15–112. 17
	48	+	2 HOUSE BILL 1351
50	49
51	50
52		-	Article – Insurance 1
53		-	Section 15–112(g) 2
54		-	Annotated Code of Maryland 3
55		-	(2017 Replacement Volume and 2024 Supplement) 4
	51	+	(g) (1) A provider that seeks to participate on a provider panel of a carrier shall 1
	52	+	submit an application to the carrier. 2
56	53
57		-	SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5
58		-	That the Laws of Maryland read as follows: 6
	54	+	(2) (i) Subject to subparagraph (ii) of this paragraph and paragraph (3) 3
	55	+	of this subsection, the carrier, after reviewing the application, shall accept or reject the 4
	56	+	provider for participation on the carrier’s provider panel. 5
59	57
60		-	Article – Insurance 7
	58	+	(ii) A carrier may not reject a provider who provides 6
	59	+	community–based health services for a program accredited under COMAR 10.63.02 for 7
	60	+	participation on the carrier’s provider panel because the provider practices within the scope 8
	61	+	of the provider’s license and is: 9
61	62
62		-	15–112. 8
	63	+	1. a licensed graduate social worker or a licensed master 10
	64	+	social worker, as those terms are defined in § 19–101 of the Health Occupations Article; 11
63	65
64		-	(g) (1) A provider that seeks to participate on a provider panel of a carrier shall 9
65		-	submit an application to the carrier. 10
	66	+	2. a licensed graduate alcohol and drug counselor, a licensed 12
	67	+	graduate marriage and family therapist, a licensed graduate professional art therapist, or 13
	68	+	a licensed graduate professional counselor, as those terms are defined in § 17–101 of the 14
	69	+	Health Occupations Article; or 15
66	70
67		-	(2) (i) Subject to subparagraph (ii) of this paragraph and paragraph (3) 11
68		-	of this subsection, the carrier, after reviewing the application, shall accept or reject the 12
69		-	provider for participation on the carrier’s provider panel. 13
	71	+	3. a registered psychology associate, as defined in § 18–101 16
	72	+	of the Health Occupations Article. 17
70	73
71		-	(ii) A carrier may not reject a provider who provides 14
72		-	community–based health services for a program accredited under COMAR 10.63.02 for 15
73		-	participation on the carrier’s provider panel because the provider practices within the scope 16
74		-	of the provider’s license and is: 17
	74	+	(iii) If the carrier rejects the provider for participation on the carrier’s 18
	75	+	provider panel, the carrier shall send to the provider at the address listed in the application 19
	76	+	written notice of the rejection. 20
75	77
76		-	1. a licensed graduate social worker or a licensed master 18
77		-	social worker, as those terms are defined in § 19–101 of the Health Occupations Article; 19
	78	+	(3) (i) [Subject] EXCEPT AS PROVIDED IN SUBPARAGRAPH (IV) OF 21
	79	+	THIS PARAGRAPH AND S UBJECT to paragraph (4) of this subsection, within 30 days after 22
	80	+	the date a carrier receives a completed application, the carrier shall send to the provider at 23
	81	+	the address listed in the application written notice of: 24
78	82
79		-	2. a licensed graduate alcohol and drug counselor, a licensed 20
80		-	graduate marriage and family therapist, a licensed graduate professional art therapist, or 21
81		-	a licensed graduate professional counselor, as those terms are defined in § 17–101 of the 22
82		-	Health Occupations Article; or 23
	83	+	1. the carrier’s intent to continue to process the provider’s 25
	84	+	application to obtain necessary credentialing information; or 26
83	85
84		-	3. ~~a registered psychology associate,~~ ~~as defined in § 18–101 24~~
85		-	of the ~~Health Occupations Article~~. 25
	86	+	2. the carrier’s rejection of the provider for participation on 27
	87	+	the carrier’s provider panel. 28
86	88
87		-	(~~iii~~) If the carrier ~~rejects~~ the ~~provider for participation on the carrier’s 26~~
88		-	~~provider panel,~~ the carrier ~~shall send~~ to ~~the provider at the address listed in the application 27~~
89		-	~~written notice~~ of ~~the rejection~~. 28
	89	+	(ii) The failure of a carrier to provide the notice required under 29
	90	+	subparagraph (i) of this paragraph is a violation of this article and the carrier is subject to 30
	91	+	the penalties provided by § 4–113(d) of this article. 31
90	92
91		-	(3) (i) [Subject] EXCEPT AS PROVIDED IN SUBPARAGRAPH (IV) OF 29
92		-	THIS PARAGRAPH AND S UBJECT to paragraph (4) of this subsection, within 30 days after 30
93		-	the date a carrier receives a completed application, the carrier shall send to the provider at 31
94		-	the address listed in the application written notice of: 32
95		-
96		-	1. the carrier’s intent to continue to process the provider’s 33
97		-	application to obtain necessary credentialing information; or 34
98		-	HOUSE BILL 1351 3
99		-
100		-
101		-	2. the carrier’s rejection of the provider for participation on 1
102		-	the carrier’s provider panel. 2
103		-
104		-	(ii) The failure of a carrier to provide the notice required under 3
105		-	subparagraph (i) of this paragraph is a violation of this article and the carrier is subject to 4
106		-	the penalties provided by § 4–113(d) of this article. 5
107		-
108		-	(iii) Except as provided in subsection (v) of this section AND 6
109		-	SUBPARAGRAPH (IV) OF THIS PARAGRAPH , if, under subparagraph (i)1 of this 7
110		-	paragraph, a carrier provides notice to the provider of its intent to continue to process the 8
111		-	provider’s application to obtain necessary credentialing information, the carrier, within 120 9
112		-	days after the date the notice is provided, shall: 10
113		-
114		-	1. accept or reject the provider for participation on the 11
115		-	carrier’s provider panel; and 12
116		-
117		-	2. send written notice of the acceptance or rejection to the 13
118		-	provider at the address listed in the application. 14
119		-
120		-	(IV) FOR A PROVIDER DESCRI BED IN PARAGRAPH (2)(II) OF THIS 15
121		-	SUBSECTION, A LICENSED CERTIFIED SOCIAL WORKER –CLINICAL, OR A LICENSED 16
122		-	CLINICAL PROFESSIONA L COUNSELOR IF, UNDER SUBPARAGRAPH (I)1 OF THIS 17
123		-	PARAGRAPH , A CARRIER PROVIDES N OTICE TO THE PROVIDE R OF ITS INTENT TO 18
124		-	CONTINUE TO PROCESS THE PROVIDER ’S APPLICATION TO OBT AIN NECESSARY 19
125		-	CREDENTIALING INFORMATION , WITHIN 30 60 DAYS AFTER THE DATE A CARRIER 20
126		-	RECEIVES A COMPLETED APPLICATION, THE CARRIER SHALL : 21
127		-
128		-	1. ACCEPT OR REJECT THE PROVIDER FOR 22
129		-	PARTICIPATION ON THE CARRIER’S PROVIDER PANEL ; AND 23
130		-
131		-	2. SEND WRITTEN NOTICE OF THE ACCEPTANCE OR 24
132		-	REJECTION TO THE PRO VIDER AT THE ADDRESS LISTED IN THE APPLIC ATION. 25
133		-
134		-	[(iv)] (V) The failure of a carrier to provide the notice required 26
135		-	under subparagraph (iii)2 OR (IV) of this paragraph is a violation of this article and the 27
136		-	carrier is subject to the provisions of and penalties provided by §§ 4–113 and 4–114 of this 28
137		-	article. 29
138		-
139		-	(4) (i) 1. Except as provided in subsubparagraph 4 of this 30
140		-	subparagraph, a carrier that receives a complete application shall notify the provider that 31
141		-	the application is complete. 32
142		-
143		-	2. If a carrier does not accept applications through the online 33
144		-	credentialing system, notice shall be given to the provider at the address listed in the 34
145		-	application within 10 days after the date the application is received. 35 4 HOUSE BILL 1351
	93	+	(iii) Except as provided in subsection (v) of this section AND 32
	94	+	SUBPARAGRAPH (IV) OF THIS PARAGRAPH , if, under subparagraph (i)1 of this 33
	95	+	paragraph, a carrier provides notice to the provider of its intent to continue to process the 34
	96	+	provider’s application to obtain necessary credentialing information, the carrier, within 120 35
	97	+	days after the date the notice is provided, shall: 36 HOUSE BILL 1351 3
146	98
147	99
148	100
149		-	3. If a carrier accepts applications through the online 1
150		-	credentialing system, the notice from the online credentialing system to the provider that 2
151		-	the carrier has received the provider’s application shall be considered notice that the 3
152		-	application is complete. 4
	101	+	1. accept or reject the provider for participation on the 1
	102	+	carrier’s provider panel; and 2
153	103
154		-	4. This subparagraph does not apply to a carrier that 5
155		-	arranges a dental provider panel until the Commissioner certifies that the online 6
156		-	credentialing system is capable of accepting the uniform credentialing form designated by 7
157		-	the Commissioner for dental provider panels. 8
	104	+	2. send written notice of the acceptance or rejection to the 3
	105	+	provider at the address listed in the application. 4
158	106
159		-	(ii) 1. A carrier that receives an incomplete application shall 9
160		-	return the application to the provider at the address listed in the application within 10 days 10
161		-	after the date the application is received. 11
	107	+	(IV) FOR A PROVIDER DESCRI BED IN PARAGRAPH (2)(II) OF THIS 5
	108	+	SUBSECTION, A LICENSED CERTIFIED SOCIAL WORKER –CLINICAL, OR A LICENSED 6
	109	+	CLINICAL PROFESSIONA L COUNSELOR IF, UNDER SUBPARAGRAPH (I)1 OF THIS 7
	110	+	PARAGRAPH , A CARRIER PROVIDES N OTICE TO THE PROVIDE R OF ITS INTENT TO 8
	111	+	CONTINUE TO PROCESS THE PROVIDER ’S APPLICATION TO OBT AIN NECESSARY 9
	112	+	CREDENTIALING INFORM ATION, WITHIN 30 60 DAYS AFTER THE DATE A CARRIER 10
	113	+	RECEIVES A COMPLETED APPLICATION, THE CARRIER SHALL : 11
162	114
163		-	2. ~~The carrier shall indicate to~~ the provider ~~what information~~ 12
164		-	~~is needed to make~~ the ~~application complete.~~ 13
	115	+	1. ACCEPT OR REJECT THE PROVIDER FOR 12
	116	+	PARTICIPATION ON THE CARRIER’S PROVIDER PANEL ; AND 13
165	117
166		-	3. The ~~provider may return the completed application to the~~ 14
167		-	~~carrier~~. 15
	118	+	2. SEND WRITTEN NOTICE OF THE ACCEPTANCE OR 14
	119	+	REJECTION TO THE PRO VIDER AT THE ADDRESS LISTED IN THE APPLIC ATION. 15
168	120
169		-	4. After the carrier receives the completed application, the 16
170		-	carrier is subject to the time periods established in paragraph (3) of this subsection. 17
	121	+	[(iv)] (V) The failure of a carrier to provide the notice required 16
	122	+	under subparagraph (iii)2 OR (IV) of this paragraph is a violation of this article and the 17
	123	+	carrier is subject to the provisions of and penalties provided by §§ 4–113 and 4–114 of this 18
	124	+	article. 19
171	125
172		-	(5) A carrier may charge a reasonable fee for an application submitted to 18
173		-	the carrier under this section. 19
	126	+	(4) (i) 1. Except as provided in subsubparagraph 4 of this 20
	127	+	subparagraph, a carrier that receives a complete application shall notify the provider that 21
	128	+	the application is complete. 22
174	129
175		-	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
176		-	October 1, 2025. 21
	130	+	2. If a carrier does not accept applications through the online 23
	131	+	credentialing system, notice shall be given to the provider at the address listed in the 24
	132	+	application within 10 days after the date the application is received. 25
	133	+
	134	+	3. If a carrier accepts applications through the online 26
	135	+	credentialing system, the notice from the online credentialing system to the provider that 27
	136	+	the carrier has received the provider’s application shall be considered notice that the 28
	137	+	application is complete. 29
	138	+
	139	+	4. This subparagraph does not apply to a carrier that 30
	140	+	arranges a dental provider panel until the Commissioner certifies that the online 31
	141	+	credentialing system is capable of accepting the uniform credentialing form designated by 32
	142	+	the Commissioner for dental provider panels. 33
	143	+	4 HOUSE BILL 1351
	144	+
	145	+
	146	+	(ii) 1. A carrier that receives an incomplete application shall 1
	147	+	return the application to the provider at the address listed in the application within 10 days 2
	148	+	after the date the application is received. 3
	149	+
	150	+	2. The carrier shall indicate to the provider what information 4
	151	+	is needed to make the application complete. 5
	152	+
	153	+	3. The provider may return the completed application to the 6
	154	+	carrier. 7
	155	+
	156	+	4. After the carrier receives the completed application, the 8
	157	+	carrier is subject to the time periods established in paragraph (3) of this subsection. 9
	158	+
	159	+	(5) A carrier may charge a reasonable fee for an application submitted to 10
	160	+	the carrier under this section. 11
	161	+
	162	+	SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
	163	+	October 1, 2025. 13
177	164
178	165
179	166
180	167
181	168		Approved:
182	169		________________________________________________________________________________
183	170		Governor.
184	171		________________________________________________________________________________
185	172		Speaker of the House of Delegates.
186	173		________________________________________________________________________________
187	174		President of the Senate.