EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0328*
SENATE BILL 328
J1, J4, J5 5lr2074
SB 124/24 – FIN
By: Senator Augustine
Introduced and read first time: January 15, 2025
Assigned to: Finance
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
Section 15–861 26
Annotated Code of Maryland 27 2 SENATE BILL 328
(2017 Replacement Volume and 2024 Supplement) 1
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 2
That the Laws of Maryland read as follows: 3
Article – Health – General 4
15–102.3. 5
(M) BEGINNING JULY 1, 2026, THE PROVISIONS OF § 15–861 OF THE 6
INSURANCE ARTICLE APPLY TO MANA GED CARE ORGANIZATIO NS IN THE SAME 7
MANNER THEY APPLY TO CARRIERS. 8
15–103. 9
(a) (1) The Secretary shall administer the Maryland Medical Assistance 10
Program. 11
(2) The Program: 12
(xxiii) Beginning on July 1, 2025, shall provide, subject to the 13
limitations of the State budget, and as permitted by federal law, coverage for biomarker 14
testing in accordance with § 15–859 of the Insurance Article; [and] 15
(xxiv) Beginning on January 1, 2025, shall provide coverage for 16
prostheses in accordance with § 15–844 of the Insurance Article; AND 17
(XXV) BEGINNING ON JULY 1, 2026, SHALL PROVIDE COVERA GE 18
FOR ANNUAL BEHAVIORA L HEALTH WEL LNESS VISITS IN ACCORDANCE WITH § 19
15–861 OF THE INSURANCE ARTICLE. 20
Article – Insurance 21
15–861. 22
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 23
INDICATED. 24
(2) “BEHAVIORAL HEALTH WEL LNESS VISIT” MEANS A CLINICAL 25
ENCOUNTER DURING WHI CH A HEALTH CARE PRA CTITIONER CONDUCTS A N 26
ASSESSMENT TO IDENTI FY WHETHER A PATIENT MEETS CRITERIA FOR A 27
PSYCHIATRIC OR SUBST ANCE USE DISORDER . 28
(3) “HEALTH CARE PRACTITIO NER” MEANS AN INDIVIDUAL: 29
SENATE BILL 328 3
(I) WHO IS LICENSED , CERTIFIED, OR OTHERWISE AUTHORI ZED 1
UNDER THE HEALTH OCCUPATIONS ARTICLE TO PRACTICE A HEALTH OCCUPATION ; 2
AND 3
(II) WHOSE SCOPE OF PRACT ICE INCLUDES THE PRO VISION OF 4
MENTAL HEALTH AND SU BSTANCE USE DISORDER CARE SERVICES. 5
(B) THIS SECTION APPLIES TO: 6
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 7
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 8
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 9
CONTRACTS THAT ARE I SSUED OR DELIVERED IN TH E STATE; AND 10
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 11
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 12
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 13
(C) (1) AN ENTITY SUBJECT TO THIS SECTION SH ALL PROVIDE 14
COVERAGE FOR AN ANNU AL BEHAVIORAL HEALTH WELLNESS VISIT , REGARDLESS 15
OF THE ASSESSMENT RE SULTING IN A BEHAVIO RAL HEALTH DIAGNOSIS . 16
(2) AN ENTITY SUBJECT TO THIS SECTION SHALL P ROVIDE 17
REIMBURSEMENT FOR AN ANNUAL BEHAVIORAL HE ALTH WELLNESS VISI T ON THE 18
SAME BASIS AND AT TH E SAME RATE AS AN AS SESSMENT THAT RESULT S IN A 19
BEHAVIORAL HEALTH DI AGNOSIS. 20
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 21
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 22
after January 1, 2026. 23
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 24
January 1, 2026. 25