EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. [Brackets] indicate matter deleted from existing law. *hb0665* HOUSE BILL 665 J1, J4, J5 5lr2863 HB 400/24 – HGO CF SB 328 By: Delegates Woods, Acevero, Alston, Bagnall, Charkoudian , Fair, Kaiser, Kaufman, R. Lewis, J. Long, Martinez, Phillips, Roberts, Ruff, Ruth, Simmons, Solomon, Taylor, Terrasa, Valderrama, and Williams Introduced and read first time: January 24, 2025 Assigned to: Health and Government Operations A BILL ENTITLED AN ACT concerning 1 Maryland Medical Assistance Program and Health Insurance – Annual 2 Behavioral Health Wellness Visits – Coverage and Reimbursement 3 FOR the purpose of requiring the Maryland Medical Assistance Program and certain health 4 insurers, nonprofit health service plans, and health maintenance organizations to 5 provide coverage and certain reimbursement for annual behavioral health wellness 6 visits; and generally relating to coverage and reimbursement for behavioral health 7 care services. 8 BY adding to 9 Article – Health – General 10 Section 15–102.3(m) and 15–103(a)(2)(xxv) 11 Annotated Code of Maryland 12 (2023 Replacement Volume and 2024 Supplement) 13 BY repealing and reenacting, without amendments, 14 Article – Health – General 15 Section 15–103(a)(1) 16 Annotated Code of Maryland 17 (2023 Replacement Volume and 2024 Supplement) 18 BY repealing and reenacting, with amendments, 19 Article – Health – General 20 Section 15–103(a)(2)(xxiii) and (xxiv) 21 Annotated Code of Maryland 22 (2023 Replacement Volume and 2024 Supplement) 23 BY adding to 24 Article – Insurance 25 2 HOUSE BILL 665 Section 15–861 1 Annotated Code of Maryland 2 (2017 Replacement Volume and 2024 Supplement) 3 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 4 That the Laws of Maryland read as follows: 5 Article – Health – General 6 15–102.3. 7 (M) BEGINNING JULY 1, 2026, THE PROVISIONS OF § 15–861 OF THE 8 INSURANCE ARTICLE APPLY TO MANA GED CARE ORGANIZATIO NS IN THE SAME 9 MANNER THEY APPLY TO CARRIERS. 10 15–103. 11 (a) (1) The Secretary shall administer the Maryland Medical Assistance 12 Program. 13 (2) The Program: 14 (xxiii) Beginning on July 1, 2025, shall provide, subject to the 15 limitations of the State budget, and as permitted by federal law, coverage for biomarker 16 testing in accordance with § 15–859 of the Insurance Article; [and] 17 (xxiv) Beginning on January 1, 2025, shall provide coverage for 18 prostheses in accordance with § 15–844 of the Insurance Article; AND 19 (XXV) BEGINNING ON JULY 1, 2026, SHALL PROVIDE COVERA GE 20 FOR ANNUAL BEHAVIORA L HEALTH WELLN ESS VISITS IN ACCORD ANCE WITH § 21 15–861 OF THE INSURANCE ARTICLE. 22 Article – Insurance 23 15–861. 24 (A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 25 INDICATED. 26 (2) “BEHAVIORAL HEALTH WEL LNESS VISIT” MEANS A CLINICAL 27 ENCOUNTER DURING WHI CH A HEALTH CARE PRACTITI ONER CONDUCTS AN 28 ASSESSMENT TO IDENTI FY WHETHER A PATIENT MEETS CRITERIA FOR A 29 PSYCHIATRIC OR SUBST ANCE USE DISORDER . 30 HOUSE BILL 665 3 (3) “HEALTH CARE PRACTITIO NER” MEANS AN INDIVIDUAL : 1 (I) WHO IS LICENSED , CERTIFIED, OR OTHERWISE AUTHORI ZED 2 UNDER THE HEALTH OCCUPATIONS ARTICLE TO PRACTICE A HEALTH OCCUPATION ; 3 AND 4 (II) WHOSE SCOPE OF PRACT ICE INCLUDES THE PRO VISION OF 5 MENTAL HEALTH AND SU BSTANCE USE DISORDER CARE SERVICES . 6 (B) THIS SECTION APPLIES TO: 7 (1) INSURERS AND NONPROF IT HEALTH SERVICE PLANS THAT 8 PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 9 ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 10 CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 11 (2) HEALTH MAINTENANCE O RGANIZATIONS TH AT PROVIDE 12 HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 13 CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 14 (C) (1) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE 15 COVERAGE FOR AN ANNU AL BEHAVIORAL HEALTH WELLNESS VISIT , REGARDLESS 16 OF THE ASSESSMENT RE SULTING IN A BEHAVIO RAL HEALTH DIAGNOSIS . 17 (2) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE 18 REIMBURSEMENT FOR AN ANNUAL BEHAVIORAL HE ALTH WELLNESS VISIT ON THE 19 SAME BASIS AND AT TH E SAME RATE AS AN AS SESSMENT THAT RESULT S IN A 20 BEHAVIORAL HEALTH DI AGNOSIS. 21 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 22 policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 23 after January 1, 2026. 24 SECTION 3. AND BE IT FURTHER ENA CTED, That this Act shall take effect 25 January 1, 2026. 26