EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
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amendment.
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*hb1351*
HOUSE BILL 1351
J5 (5lr3352)
ENROLLED BILL
— Health and Government Operations/Finance —
Introduced by Delegate Ghrist Delegates Ghrist, Alston, Bagnall , Bhandari,
Chisholm, Cullison, Guzzone, Hill, Hutchinson, S. Johnson, Kaiser, Kerr,
Kipke, Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Ross,
Szeliga, Taveras, White Holland, Woods, and Woorman
Read and Examined by Proofreaders:
_______________________________________________
Proofreader.
_______________________________________________
Proofreader.
Sealed with the Great Seal and presented to the Governor, for his approval this
_______ day of _______________ at ________________________ o’clock, ________M.
______________________________________________
Speaker.
CHAPTER ______
AN ACT concerning 1
Health Insurance – Provider Panels – Credentialing for Behavioral Health Care 2
Professionals 3
FOR the purpose of altering the providers of certain community–based health services that 4
a carrier is prohibited from rejecting for participation on the carrier’s provider panel; 5
altering the period of time in which certain carriers are required to accept or deny 6
certain social workers, counselors, therapists, and psychology associates for 7
participation on the carrier’s provider panel; and generally relating to and the 8
credentialing of behavioral health care professionals for health insurance provider 9
panels. 10
BY repealing and reenacting, with amendments, 11 2 HOUSE BILL 1351
Article – Insurance 1
Section 15–112(g) 2
Annotated Code of Maryland 3
(2017 Replacement Volume and 2024 Supplement) 4
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 5
That the Laws of Maryland read as follows: 6
Article – Insurance 7
15–112. 8
(g) (1) A provider that seeks to participate on a provider panel of a carrier shall 9
submit an application to the carrier. 10
(2) (i) Subject to subparagraph (ii) of this paragraph and paragraph (3) 11
of this subsection, the carrier, after reviewing the application, shall accept or reject the 12
provider for participation on the carrier’s provider panel. 13
(ii) A carrier may not reject a provider who provides 14
community–based health services for a program accredited under COMAR 10.63.02 for 15
participation on the carrier’s provider panel because the provider practices within the scope 16
of the provider’s license and is: 17
1. a licensed graduate social worker or a licensed master 18
social worker, as those terms are defined in § 19–101 of the Health Occupations Article; 19
2. a licensed graduate alcohol and drug counselor, a licensed 20
graduate marriage and family therapist, a licensed graduate professional art therapist, or 21
a licensed graduate professional counselor, as those terms are defined in § 17–101 of the 22
Health Occupations Article; or 23
3. a registered psychology associate, as defined in § 18–101 24
of the Health Occupations Article. 25
(iii) If the carrier rejects the provider for participation on the carrier’s 26
provider panel, the carrier shall send to the provider at the address listed in the application 27
written notice of the rejection. 28
(3) (i) [Subject] EXCEPT AS PROVIDED IN SUBPARAGRAPH (IV) OF 29
THIS PARAGRAPH AND S UBJECT to paragraph (4) of this subsection, within 30 days after 30
the date a carrier receives a completed application, the carrier shall send to the provider at 31
the address listed in the application written notice of: 32
1. the carrier’s intent to continue to process the provider’s 33
application to obtain necessary credentialing information; or 34
HOUSE BILL 1351 3
2. the carrier’s rejection of the provider for participation on 1
the carrier’s provider panel. 2
(ii) The failure of a carrier to provide the notice required under 3
subparagraph (i) of this paragraph is a violation of this article and the carrier is subject to 4
the penalties provided by § 4–113(d) of this article. 5
(iii) Except as provided in subsection (v) of this section AND 6
SUBPARAGRAPH (IV) OF THIS PARAGRAPH , if, under subparagraph (i)1 of this 7
paragraph, a carrier provides notice to the provider of its intent to continue to process the 8
provider’s application to obtain necessary credentialing information, the carrier, within 120 9
days after the date the notice is provided, shall: 10
1. accept or reject the provider for participation on the 11
carrier’s provider panel; and 12
2. send written notice of the acceptance or rejection to the 13
provider at the address listed in the application. 14
(IV) FOR A PROVIDER DESCRI BED IN PARAGRAPH (2)(II) OF THIS 15
SUBSECTION, A LICENSED CERTIFIED SOCIAL WORKER –CLINICAL, OR A LICENSED 16
CLINICAL PROFESSIONA L COUNSELOR IF, UNDER SUBPARAGRAPH (I)1 OF THIS 17
PARAGRAPH , A CARRIER PROVIDES N OTICE TO THE PROVIDE R OF ITS INTENT TO 18
CONTINUE TO PROCESS THE PROVIDER ’S APPLICATION TO OBT AIN NECESSARY 19
CREDENTIALING INFORMATION , WITHIN 30 60 DAYS AFTER THE DATE A CARRIER 20
RECEIVES A COMPLETED APPLICATION, THE CARRIER SHALL : 21
1. ACCEPT OR REJECT THE PROVIDER FOR 22
PARTICIPATION ON THE CARRIER’S PROVIDER PANEL ; AND 23
2. SEND WRITTEN NOTICE OF THE ACCEPTANCE OR 24
REJECTION TO THE PRO VIDER AT THE ADDRESS LISTED IN THE APPLIC ATION. 25
[(iv)] (V) The failure of a carrier to provide the notice required 26
under subparagraph (iii)2 OR (IV) of this paragraph is a violation of this article and the 27
carrier is subject to the provisions of and penalties provided by §§ 4–113 and 4–114 of this 28
article. 29
(4) (i) 1. Except as provided in subsubparagraph 4 of this 30
subparagraph, a carrier that receives a complete application shall notify the provider that 31
the application is complete. 32
2. If a carrier does not accept applications through the online 33
credentialing system, notice shall be given to the provider at the address listed in the 34
application within 10 days after the date the application is received. 35 4 HOUSE BILL 1351
3. If a carrier accepts applications through the online 1
credentialing system, the notice from the online credentialing system to the provider that 2
the carrier has received the provider’s application shall be considered notice that the 3
application is complete. 4
4. This subparagraph does not apply to a carrier that 5
arranges a dental provider panel until the Commissioner certifies that the online 6
credentialing system is capable of accepting the uniform credentialing form designated by 7
the Commissioner for dental provider panels. 8
(ii) 1. A carrier that receives an incomplete application shall 9
return the application to the provider at the address listed in the application within 10 days 10
after the date the application is received. 11
2. The carrier shall indicate to the provider what information 12
is needed to make the application complete. 13
3. The provider may return the completed application to the 14
carrier. 15
4. After the carrier receives the completed application, the 16
carrier is subject to the time periods established in paragraph (3) of this subsection. 17
(5) A carrier may charge a reasonable fee for an application submitted to 18
the carrier under this section. 19
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
October 1, 2025. 21
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.