MD
Maryland House Bill HB869

Maryland 2025 Regular Session

Maryland House Bill HB869 Compare Versions

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33 EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
44 [Brackets] indicate matter deleted from existing law.
55 Underlining indicates amendments to bill.
66 Strike out indicates matter stricken from the bill by amendment or deleted from the law by
77 amendment.
8- Italics indicate opposite chamber/conference committee amendments.
98 *hb0869*
109
1110 HOUSE BILL 869
12-J5, J1 (5lr1874)
13-ENROLLED BILL
14-— Health and Government Operations/Finance —
15-Introduced by Delegates Pena–Melnyk, Bagnall, Cullison, Kerr, and Rosenberg
16-Rosenberg, Alston, Bhandari, Chisholm, Guzzone, Hill, Hutchinson,
17-S. Johnson, Kaiser, Kipke, Lopez, Martinez, M. Morgan, Reilly, Szeliga,
18-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.
11+J5, J1 5lr1874
12+ CF SB 372
13+By: Delegates Pena–Melnyk, Bagnall, Cullison, Kerr, and Rosenberg Rosenberg,
14+Alston, Bhandari, Chisholm, Guzzone, Hill, Hutchinson, S. Johnson, Kaiser,
15+Kipke, Lopez, Martinez, M. Morgan, Reilly, Szeliga, Taveras, White Holland,
16+Woods, and Woorman
17+Introduced and read first time: January 30, 2025
18+Assigned to: Health and Government Operations
19+Committee Report: Favorable with amendments
20+House action: Adopted
21+Read second time: February 22, 2025
3322
3423 CHAPTER ______
3524
3625 AN ACT concerning 1
3726
3827 Preserve Telehealth Access Act of 2025 2
3928
4029 FOR the purpose of repealing the limitation on the period during which certain audio–only 3
4130 telephone conversations are included under the definition of “telehealth” for the 4
4231 purpose of certain provisions of law relating to reimbursement and coverage of 5
4332 telehealth by the Maryland Medical Assistance Program and certain insurers, 6
4433 nonprofit health service plans, and health maintenance organizations; repealing the 7
4534 limitation on the period during which the Program and certain insurers, nonprofit 8
4635 health service plans, and health maintenance organizations are required to provide 9
4736 reimbursement for certain health care services provided through telehealth on a 10
48-certain basis and at a certain rate; repealing the prohibition on altering the 11
49-circumstances under which health care practitioners prescribing are authorized to 12 2 HOUSE BILL 869
37+certain basis and at a certain rate; repealing the prohibition on health care 11
38+practitioners prescribing certain controlled dangerous substances for the treatment 12
39+of pain through telehealth; requiring the Maryland Health Care Commission to 13
40+submit a certain report regarding telehealth every certain number of years; and 14
41+generally relating to the provision, coverage, and reimbursement of health care 15
42+services delivered through telehealth. 16
43+
44+BY repealing and reenacting, with amendments, 17
45+ Article – Health – General 18
46+Section 15–141.2(a)(7) and (g) 19
47+ Annotated Code of Maryland 20
48+ (2023 Replacement Volume and 2024 Supplement) 21 2 HOUSE BILL 869
5049
5150
52-prescribe certain controlled dangerous substances for the treatment of pain through 1
53-telehealth; requiring the Maryland Health Care Commission to submit a certain 2
54-report regarding telehealth every certain number of years; and generally relating to 3
55-the provision, coverage, and reimbursement of health care services delivered through 4
56-telehealth. 5
51+
52+BY adding to 1
53+ Article – Health – General 2
54+ Section 19–108.6 3
55+ Annotated Code of Maryland 4
56+ (2023 Replacement Volume and 2024 Supplement) 5
5757
5858 BY repealing and reenacting, with amendments, 6
59- Article – Health – General 7
60-Section 15–141.2(a)(7) and (g) 8
59+ Article – Health Occupations 7
60+ Section 1–1003 8
6161 Annotated Code of Maryland 9
62- (2023 Replacement Volume and 2024 Supplement) 10
62+ (2021 Replacement Volume and 2024 Supplement) 10
6363
64-BY adding to 11
65- Article – Health – General 12
66- Section 19–108.6 13
64+BY repealing and reenacting, with amendments, 11
65+ Article – Insurance 12
66+Section 15–139(a) and (d) 13
6767 Annotated Code of Maryland 14
68- (2023 Replacement Volume and 2024 Supplement) 15
68+ (2017 Replacement Volume and 2024 Supplement) 15
6969
70-BY repealing and reenacting, with amendments, 16
71- Article – Health Occupations 17
72- Section 1–1003 18
70+BY repealing and reenacting, without amendments, 16
71+ Article – Insurance 17
72+Section 15–139(b) and (c) 18
7373 Annotated Code of Maryland 19
74- (2021 Replacement Volume and 2024 Supplement) 20
74+ (2017 Replacement Volume and 2024 Supplement) 20
7575
76-BY repealing and reenacting, with amendments, 21
77- Article – Insurance 22
78-Section 15–139(a) and (d) 23
79- Annotated Code of Maryland 24
80- (2017 Replacement Volume and 2024 Supplement) 25
76+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 21
77+That the Laws of Maryland read as follows: 22
8178
82-BY repealing and reenacting, without amendments, 26
83- Article – Insurance 27
84-Section 15–139(b) and (c) 28
85- Annotated Code of Maryland 29
86- (2017 Replacement Volume and 2024 Supplement) 30
79+Article – Health – General 23
8780
88- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 31
89-That the Laws of Maryland read as follows: 32
81+15–141.2. 24
9082
91-Article – Health – General 33
83+ (a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 25
84+dental, or behavioral health services to a patient at an originating site by a distant site 26
85+provider through the use of technology–assisted communication. 27
9286
93-15–141.2. 34
87+ (ii) “Telehealth” includes: 28
9488
95- (a) (7) (i) “Telehealth” means the delivery of medically necessary somatic, 35
96-dental, or behavioral health services to a patient at an originating site by a distant site 36
97-provider through the use of technology–assisted communication. 37
89+ 1. Synchronous and asynchronous interactions; 29
90+
91+ 2. [From July 1, 2021, to June 30, 2025, both inclusive, an] 30
92+AN audio–only telephone conversation between a health care provider and a patient that 31
93+results in the delivery of a billable, covered health care service; and 32
94+
95+ 3. Remote patient monitoring services. 33
9896 HOUSE BILL 869 3
9997
10098
101- (ii) “Telehealth” includes: 1
99+ (iii) “Telehealth” does not include the provision of health care 1
100+services solely through: 2
102101
103- 1. Synchronous and asynchronous interactions; 2
102+ 1. Except as provided in subparagraph (ii)2 of this 3
103+paragraph, an audio–only telephone conversation; 4
104104
105- 2. [From July 1, 2021, to June 30, 2025, both inclusive, an] 3
106-AN audio–only telephone conversation between a health care provider and a patient that 4
107-results in the delivery of a billable, covered health care service; and 5
105+ 2. An e–mail message; or 5
108106
109- 3. Remote patient monitoring services. 6
107+ 3. A facsimile transmission. 6
110108
111- (iii) “Telehealth” does not include the provision of health care 7
112-services solely through: 8
109+ (g) (1) Subject to paragraph (3) of this subsection, the Program shall 7
110+reimburse a health care provider for the diagnosis, consultation, and treatment of a 8
111+Program recipient for a health care service covered by the Program that can be 9
112+appropriately provided through telehealth. 10
113113
114- 1. Except as provided in subparagraph (ii)2 of this 9
115-paragraph, an audio–only telephone conversation; 10
114+ (2) This subsection does not require the Program to reimburse a health 11
115+care provider for a health care service delivered in person or through telehealth that is: 12
116116
117- 2. An e–mail message; or 11
117+ (i) Not a covered health care service under the Program; or 13
118118
119- 3. A facsimile transmission. 12
119+ (ii) Delivered by an out–of–network provider unless the health care 14
120+service is a self–referred service authorized under the Program. 15
120121
121- (g) (1) Subject to paragraph (3) of this subsection, the Program shall 13
122-reimburse a health care provider for the diagnosis, consultation, and treatment of a 14
123-Program recipient for a health care service covered by the Program that can be 15
124-appropriately provided through telehealth. 16
122+ (3) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 16
123+WHEN appropriately provided through telehealth, the Program shall provide 17
124+reimbursement in accordance with paragraph (1) of this subsection on the same basis and 18
125+the same rate as if the health care service were delivered by the health care provider in 19
126+person. 20
125127
126- (2) This subsection does not require the Program to reimburse a health 17
127-care provider for a health care service delivered in person or through telehealth that is: 18
128+ (ii) The reimbursement required under subparagraph (i) of this 21
129+paragraph does not include: 22
128130
129- (i) Not a covered health care service under the Program; or 19
131+ 1. Clinic facility fees unless the health care service is 23
132+provided by a health care provider not authorized to bill a professional fee separately for 24
133+the health care service; or 25
130134
131- (ii) Delivered by an out–of–network provider unless the health care 20
132-service is a self–referred service authorized under the Program. 21
135+ 2. Any room and board fees. 26
133136
134- (3) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 22
135-WHEN appropriately provided through telehealth, the Program shall provide 23
136-reimbursement in accordance with paragraph (1) of this subsection on the same basis and 24
137-the same rate as if the health care service were delivered by the health care provider in 25
138-person. 26
137+19–108.6. 27
139138
140- (ii) The reimbursement required under subparagraph (i) of this 27
141-paragraph does not include: 28
142-
143- 1. Clinic facility fees unless the health care service is 29
144-provided by a health care provider not authorized to bill a professional fee separately for 30
145-the health care service; or 31
139+ ON OR BEFORE DECEMBER 1 EVERY 4 YEARS, BEGINNING IN 2026, THE 28
140+COMMISSION SHALL SUBM IT A REPORT TO THE GOVERNOR AND , IN ACCORDANCE 29
141+WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY 30
142+THAT INCLUDES : 31
146143 4 HOUSE BILL 869
147144
148145
149- 2. Any room and board fees. 1
146+ (1) ADVANCES OR DEVELOPME NTS IN THE AREA OF T ELEHEALTH, 1
147+INCLUDING: 2
150148
151-19–108.6. 2
149+ (I) EVOLVING MODALITIES O F TELEHEALTH DELIVER Y; AND 3
152150
153- ON OR BEFORE DECEMBER 1 EVERY 4 YEARS, BEGINNING IN 2026, THE 3
154-COMMISSION SHALL SUBM IT A REPORT TO THE GOVERNOR AND , IN ACCORDANCE 4
155-WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, THE GENERAL ASSEMBLY 5
156-THAT INCLUDES : 6
151+ (II) CHANGES IN THE COSTS OF DELIVERING TELEHEALT H 4
152+SERVICES; AND 5
157153
158- (1) ADVANCES OR DEVELOPME NTS IN THE AREA OF T ELEHEALTH, 7
159-INCLUDING: 8
154+ (2) ANY FINDINGS OR RECOM MENDATIONS OF THE COMMISSION. 6
160155
161- (I) EVOLVING MODALITIES O F TELEHEALTH DELIVER Y; AND 9
156+Article – Health Occupations 7
162157
163- (II) CHANGES IN THE COSTS OF DELIVERING TELEHE ALTH 10
164-SERVICES; AND 11
158+1–1003. 8
165159
166- (2) ANY FINDINGS OR RECOM MENDATIONS OF THE COMMISSION. 12
160+ (a) A health care practitioner providing telehealth services shall: 9
167161
168-Article – Health Occupations 13
162+ (1) Be held to the same standards of practice that are applicable to 10
163+in–person health care settings; and 11
169164
170-1–1003. 14
165+ (2) If clinically appropriate for the patient, provide or refer a patient to 12
166+in–person health care services or another type of telehealth service. 13
171167
172- (a) A health care practitioner providing telehealth services shall: 15
168+ (b) (1) A health care practitioner shall perform a clinical evaluation that is 14
169+appropriate for the patient and the condition with which the patient presents before 15
170+providing treatment or issuing a prescription through telehealth. 16
173171
174- (1) Be held to the same standards of practice that are applicable to 16
175-in–person health care settings; and 17
172+ (2) A health care practitioner may use a synchronous telehealth interaction 17
173+or an asynchronous telehealth interaction to perform the clinical evaluation required under 18
174+paragraph (1) of this subsection. 19
176175
177- (2) If clinically appropriate for the patient, provide or refer a patient to 18
178-in–person health care services or another type of telehealth service. 19
176+ (c) [(1) A health care practitioner may not prescribe an opiate described in the 20
177+list of Schedule II substances under § 5–403 of the Criminal Law Article for the treatment 21
178+of pain through telehealth, unless: 22
179179
180- (b) (1) A health care practitioner shall perform a clinical evaluation that is 20
181-appropriate for the patient and the condition with which the patient presents before 21
182-providing treatment or issuing a prescription through telehealth. 22
180+ (i) The individual receiving the prescription is a patient in a health 23
181+care facility, as defined in § 19–114 of the Health – General Article; or 24
183182
184- (2) A health care practitioner may use a synchronous telehealth interaction 23
185-or an asynchronous telehealth interaction to perform the clinical evaluation required under 24
186-paragraph (1) of this subsection. 25
183+ (ii) The Governor has declared a state of emergency due to a 25
184+catastrophic health emergency. 26
187185
188- (c) [(1) A health care practitioner may not prescribe an opiate described in the 26
189-list of Schedule II substances under § 5–403 of the Criminal Law Article for the treatment 27
190-of pain through telehealth, unless: 28
191-
192- (i) The individual receiving the prescription is a patient in a health 29
193-care facility, as defined in § 19–114 of the Health – General Article; or 30
186+ (2) Subject to paragraph (1) of this subsection, a] A health care practitioner 27
187+who through telehealth prescribes a controlled dangerous substance, as defined in § 5–101 28
188+of the Criminal Law Article, is subject to any applicable regulation, limitation, and 29
189+prohibition in federal and State law relating to the prescription of controlled dangerous 30
190+substances. 31
194191 HOUSE BILL 869 5
195192
196193
197- (ii) The Governor has declared a state of emergency due to a 1
198-catastrophic health emergency; OR 2
194+Article – Insurance 1
199195
200- (III) THERE IS AN ESTABLISH ED BONA FIDE 3
201-PRACTITIONER –PATIENT RELATIONSHIP IN WHICH THE HEALTH CARE 4
202-PRACTITIONER HAS ONG OING RESPONSIBILITY FOR THE ASSESSMENT , CARE, AND 5
203-TREATMENT OF THE PAT IENT AND THE HEALTH CARE PRACTITIONER , OR ANOTHER 6
204-HEALTH CARE PRACTITI ONER IN THE SAME GRO UP PRACTICE , PREVIOUSLY 7
205-CONDUCTED AN IN –PERSON ASSE SSMENT OF THE PATIEN T. 8
196+15–139. 2
206197
207- (2) Subject to paragraph (1) of this subsection, a] A health care practitioner 9
208-who through telehealth prescribes a controlled dangerous substance, as defined in § 5–101 10
209-of the Criminal Law Article, is subject to any applicable regulation, limitation, and 11
210-prohibition in federal and State law relating to the prescription of controlled dangerous 12
211-substances. 13
198+ (a) (1) In this section, “telehealth” means, as it relates to the delivery of health 3
199+care services, the use of interactive audio, video, or other telecommunications or electronic 4
200+technology by a licensed health care provider to deliver a health care service within the 5
201+scope of practice of the health care provider at a location other than the location of the 6
202+patient. 7
212203
213-Article – Insurance 14
204+ (2) “Telehealth” includes [from July 1, 2021, to June 30, 2025, both 8
205+inclusive,] an audio–only telephone conversation between a health care provider and a 9
206+patient that results in the delivery of a billable, covered health care service. 10
214207
215-15–139. 15
208+ (3) “Telehealth” does not include: 11
216209
217- (a) (1) In this section, “telehealth” means, as it relates to the delivery of health 16
218-care services, the use of interactive audio, video, or other telecommunications or electronic 17
219-technology by a licensed health care provider to deliver a health care service within the 18
220-scope of practice of the health care provider at a location other than the location of the 19
221-patient. 20
210+ (i) except as provided in paragraph (2) of this subsection, an 12
211+audio–only telephone conversation between a health care provider and a patient; 13
222212
223- (2) “Telehealth” includes [from July 1, 2021, to June 30, 2025, both 21
224-inclusive,] an audio–only telephone conversation between a health care provider and a 22
225-patient that results in the delivery of a billable, covered health care service. 23
213+ (ii) an electronic mail message between a health care provider and a 14
214+patient; or 15
226215
227- (3) “Telehealth” does not include: 24
216+ (iii) a facsimile transmission between a health care provider and a 16
217+patient. 17
228218
229- (i) except as provided in paragraph (2) of this subsection, an 25
230-audio–only telephone conversation between a health care provider and a patient; 26
219+ (b) This section applies to: 18
231220
232- (ii) an electronic mail message between a health care provider and a 27
233-patient; or 28
221+ (1) insurers and nonprofit health service plans that provide hospital, 19
222+medical, or surgical benefits to individuals or groups on an expense–incurred basis under 20
223+health insurance policies or contracts that are issued or delivered in the State; and 21
234224
235- (iii) a facsimile transmission between a health care provider and a 29
236-patient. 30
225+ (2) health maintenance organizations that provide hospital, medical, or 22
226+surgical benefits to individuals or groups under contracts that are issued or delivered in 23
227+the State. 24
237228
238- (b) This section applies to: 31
229+ (c) (1) An entity subject to this section: 25
239230
240- (1) insurers and nonprofit health service plans that provide hospital, 32
241-medical, or surgical benefits to individuals or groups on an expense–incurred basis under 33
242-health insurance policies or contracts that are issued or delivered in the State; and 34 6 HOUSE BILL 869
231+ (i) shall provide coverage under a health insurance policy or 26
232+contract for health care services appropriately delivered through telehealth regardless of 27
233+the location of the patient at the time the telehealth services are provided; 28
234+
235+ (ii) may not exclude from coverage a health care service solely 29
236+because it is provided through telehealth and is not provided through an in–person 30
237+consultation or contact between a health care provider and a patient; and 31
238+
239+ (iii) may not exclude from coverage or deny coverage for a behavioral 32
240+health care service that is a covered benefit under a health insurance policy or contract 33 6 HOUSE BILL 869
243241
244242
243+when provided in person solely because the behavioral health care service may also be 1
244+provided through a covered telehealth benefit. 2
245245
246- (2) health maintenance organizations that provide hospital, medical, or 1
247-surgical benefits to individuals or groups under contracts that are issued or delivered in 2
248-the State. 3
246+ (2) The health care services appropriately delivered through telehealth 3
247+shall include counseling and treatment for substance use disorders and mental health 4
248+conditions. 5
249249
250- (c) (1) An entity subject to this section: 4
250+ (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 6
251+section: 7
251252
252- (i) shall provide coverage under a health insurance policy or 5
253-contract for health care services appropriately delivered through telehealth regardless of 6
254-the location of the patient at the time the telehealth services are provided; 7
253+ (i) shall reimburse a health care provider for the diagnosis, 8
254+consultation, and treatment of an insured patient for a health care service covered under a 9
255+health insurance policy or contract that can be appropriately provided through telehealth; 10
255256
256- (ii) may not exclude from coverage a health care service solely 8
257-because it is provided through telehealth and is not provided through an in–person 9
258-consultation or contact between a health care provider and a patient; and 10
257+ (ii) is not required to: 11
259258
260- (iii) may not exclude from coverage or deny coverage for a behavioral 11
261-health care service that is a covered benefit under a health insurance policy or contract 12
262-when provided in person solely because the behavioral health care service may also be 13
263-provided through a covered telehealth benefit. 14
259+ 1. reimburse a health care provider for a health care service 12
260+delivered in person or through telehealth that is not a covered benefit under the health 13
261+insurance policy or contract; or 14
264262
265- (2) The health care services appropriately delivered through telehealth 15
266-shall include counseling and treatment for substance use disorders and mental health 16
267-conditions. 17
263+ 2. reimburse a health care provider who is not a covered 15
264+provider under the health insurance policy or contract; and 16
268265
269- (d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 18
270-section: 19
266+ (iii) 1. may impose a deductible, copayment, or coinsurance 17
267+amount on benefits for health care services that are delivered either through an in–person 18
268+consultation or through telehealth; 19
271269
272- (i) shall reimburse a health care provider for the diagnosis, 20
273-consultation, and treatment of an insured patient for a health care service covered under a 21
274-health insurance policy or contract that can be appropriately provided through telehealth; 22
270+ 2. may impose an annual dollar maximum as permitted by 20
271+federal law; and 21
275272
276- (ii) is not required to: 23
273+ 3. may not impose a lifetime dollar maximum. 22
277274
278- 1. reimburse a health care provider for a health care service 24
279-delivered in person or through telehealth that is not a covered benefit under the health 25
280-insurance policy or contract; or 26
275+ (2) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 23
276+WHEN a health care service is appropriately provided through telehealth, an entity subject 24
277+to this section shall provide reimbursement in accordance with paragraph (1)(i) of this 25
278+subsection on the same basis and at the same rate as if the health care service were 26
279+delivered by the health care provider in person. 27
281280
282- 2. reimburse a health care provider who is not a covered 27
283-provider under the health insurance policy or contract; and 28
281+ (ii) The reimbursement required under subparagraph (i) of this 28
282+paragraph does not include: 29
284283
285- (iii) 1. may impose a deductible, copayment, or coinsurance 29
286-amount on benefits for health care services that are delivered either through an in–person 30
287-consultation or through telehealth; 31
284+ 1. clinic facility fees unless the health care service is 30
285+provided by a health care provider not authorized to bill a professional fee separately for 31
286+the health care service; or 32
288287
289- 2. may impose an annual dollar maximum as permitted by 32
290-federal law; and 33
288+ 2. any room and board fees. 33
291289 HOUSE BILL 869 7
292290
293291
294- 3. may not impose a lifetime dollar maximum. 1
292+ (iii) This paragraph may not be construed to supersede the authority 1
293+of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 2
294+including setting the hospital facility fee for hospital–provided telehealth. 3
295295
296- (2) (i) [From July 1, 2021, to June 30, 2025, both inclusive, when] 2
297-WHEN a health care service is appropriately provided through telehealth, an entity subject 3
298-to this section shall provide reimbursement in accordance with paragraph (1)(i) of this 4
299-subsection on the same basis and at the same rate as if the health care service were 5
300-delivered by the health care provider in person. 6
296+ SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect June 4
297+1, 2025. 5
301298
302- (ii) The reimbursement required under subparagraph (i) of this 7
303-paragraph does not include: 8
304-
305- 1. clinic facility fees unless the health care service is 9
306-provided by a health care provider not authorized to bill a professional fee separately for 10
307-the health care service; or 11
308-
309- 2. any room and board fees. 12
310-
311- (iii) This paragraph may not be construed to supersede the authority 13
312-of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 14
313-including setting the hospital facility fee for hospital–provided telehealth. 15
314-
315- SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 16
316-June 1, 2025. 17
317299
318300
319301
320302 Approved:
321303 ________________________________________________________________________________
322304 Governor.
323305 ________________________________________________________________________________
324306 Speaker of the House of Delegates.
325307 ________________________________________________________________________________
326308 President of the Senate.