EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*sb0876*
SENATE BILL 876
J1 5lr2482
CF 5lr3525
By: Senators Hershey and Mautz
Introduced and read first time: January 28, 2025
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Maryland Medical Assistance Program – Coverage for the Treatment of Obesity 2
FOR the purpose of requiring, beginning on a certain date, the Maryland Medical 3
Assistance Program to provide comprehensive coverage for the treatment of obesity; 4
requiring the Maryland Department of Health to provide notice to Program 5
recipients of the coverage requirements; and generally relating to the Maryland 6
Medical Assistance Program and coverage for the treatment of obesity. 7
BY repealing and reenacting, without amendments, 8
Article – Health – General 9
Section 15–103(a)(1) 10
Annotated Code of Maryland 11
(2023 Replacement Volume and 2024 Supplement) 12
BY repealing and reenacting, with amendments, 13
Article – Health – General 14
Section 15–103(a)(2)(xxiii) and (xxiv) 15
Annotated Code of Maryland 16
(2023 Replacement Volume and 2024 Supplement) 17
BY adding to 18
Article – Health – General 19
Section 15–103(a)(2)(xxv) and 15–157 20
Annotated Code of Maryland 21
(2023 Replacement Volume and 2024 Supplement) 22
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 23
That the Laws of Maryland read as follows: 24
Article – Health – General 25
2 SENATE BILL 876
15–103. 1
(a) (1) The Secretary shall administer the Maryland Medical Assistance 2
Program. 3
(2) The Program: 4
(xxiii) Beginning on July 1, 2025, shall provide, subject to the 5
limitations of the State budget, and as permitted by federal law, coverage for biomarker 6
testing in accordance with § 15–859 of the Insurance Article; [and] 7
(xxiv) Beginning on January 1, 2025, shall provide coverage for 8
prostheses in accordance with § 15–844 of the Insurance Article; AND 9
(XXV) BEGINNING ON JULY 1, 2026, SHALL PROVIDE 10
COMPREHENSIVE COVERA GE FOR THE TREATMENT OF OBESITY IN ACCORD ANCE 11
WITH § 15–157 OF THIS SUBTITLE . 12
15–157. 13
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 14
INDICATED. 15
(2) “COMPREHENSIVE COVERAG E FOR THE TREATMENT OF OBESITY” 16
INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY, BARIATRIC SURGERY , 17
AND FDA–APPROVED ANTI –OBESITY MEDICATION . 18
(3) “FDA–APPROVED ANTI –OBESITY MEDICATION ” MEANS ANY 19
MEDICATION APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION WITH 20
AN INDICATION FOR CH RONIC WEIGHT MANAGEM ENT IN PATIENTS WITH OBESITY. 21
(B) THE PROGRAM SHALL PROVIDE COMPREHENSIVE COVERA GE FOR THE 22
TREATME NT OF OBESITY. 23
(C) COVERAGE CRITERIA FOR FDA–APPROVED ANTI –OBESITY 24
MEDICATIONS PROVIDED UNDER THIS SECTION M AY NOT BE MORE RESTR ICTIVE 25
THAN THE FDA–APPROVED ANTI –OBESITY MEDICATION ’S INDICATIONS FOR 26
TREATMENT . 27
(D) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEMENT TO 28
DETERMINE THE MEDICA L NECESSITY AND APPR OPRIATENESS FOR TREA TMENT OF 29
OBESITY UNDER THIS S ECTION IF THE DETERM INATIONS ARE MADE IN THE SAME 30
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 31
ILLNESS, CONDITION, OR DISORDER COVERE D BY THE PROGRAM. 32 SENATE BILL 876 3
(E) THE DEPARTMENT SHALL PROV IDE NOTICE TO PROGRAM RECIPIENTS 1
OF THE COVERAGE REQU IRED UNDER THIS SECT ION. 2
SECTION 2. AND BE IT FURTHER ENACTED, That, on or before June 1, 2026, 3
the Maryland Department of Health shall provide notice to Maryland Medical Assistance 4
Program recipients of the coverage required by this Act in writing, and prominently 5
positioned in any literature or correspondence sent to Program recipients about coverage 6
available under the Program in calendar year 2026. 7
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 8
October 1, 2025. 9