SB 898 requires Maryland’s Medical Assistance Program to reimburse applied behavior analysis (ABA) services provided by registered behavior technicians (RBTs) to Medicaid recipients diagnosed with autism spectrum disorder. The bill prohibits the state health department from mandating a specific certification (e.g., from the Behavior Analyst Certification Board) as a condition for reimbursement, except for a 150-day transition period during which RBTs must obtain certification. This directly affects Medicaid beneficiaries with autism and RBTs who deliver ABA services under supervision of certified professionals, streamlining access to care without immediate certification barriers. The law takes effect October 1, 2026, and applies prospectively only.
SB 794 creates a special enrollment period for pregnancy in Maryland health insurance. It allows individuals who become pregnant (confirmed by a healthcare provider) to choose whether their coverage starts on the first day of the month they receive pregnancy confirmation or the first day of the following month. If they don’t select a date, the insurance company must choose one of these two options. This applies to both marketplace and non-marketplace health plans and takes effect January 1, 2027. The bill directly affects pregnant individuals and parents enrolling dependents during this 90-day special enrollment period.
SB 892 modifies Maryland's State Advisory Council on Health and Wellness to include a member with expertise in perimenopausal, menopausal, and postmenopausal care. It requires health occupations boards (like those for nurses or doctors) to grant at least two continuing education credits for every hour of training on these conditions, directly affecting healthcare professionals renewing their licenses. The bill also mandates the Maryland Health Care Commission, Commission for Women, and Department of Health to take specific actions related to these health conditions. These changes aim to improve provider knowledge and care for women experiencing these common health transitions.
SB 813 prohibits dental insurers and plan organizations from blocking direct payments to dentists (nonpreferred providers) when patients assign benefits to them, instead of paying patients who then pay dentists. It requires dentists to provide patients with clear cost disclosures - including potential balance billing - before services and submit a disclosure form to insurers. The bill applies specifically to dental care under Maryland law, amending sections 14-205.3 and adding 14-410.1 to the Insurance Article. Insurers may refuse direct payment only in limited cases, such as if a patient paid the dentist upfront or withdrew assignment after payment. This aims to simplify reimbursement for dental patients and dentists outside insurance networks.
SB 839 requires Maryland's Department of Health to conduct a survey of pharmacy dispensing costs in the state every three years starting in 2026. Within six months after each survey, the Department must establish a fee charged to pharmacies for dispensing drugs under the state's Medical Assistance Program (Medicaid). This fee will be based directly on the survey results, aiming to reflect actual dispensing costs. The bill applies specifically to pharmacies participating in Maryland's Medicaid program and takes effect October 1, 2026.
HB 1470 requires Maryland's Department of Health to conduct an in-state cost-of-dispensing survey for Medicaid drugs at least once every three years, starting in 2026. Within six months after each survey, the Department must set a fee-for-service reimbursement rate for pharmacists dispensing Medicaid-covered drugs based on the survey results. This directly affects pharmacies participating in Maryland's Medical Assistance Program (Medicaid), as the new fee structure will determine their reimbursement for drug dispensing services. The bill establishes a regular, data-driven process to update these fees, ensuring they reflect actual dispensing costs.
SB 521 requires health insurance companies to notify patients in writing when a primary care provider or behavioral health provider is removed from their network, including the reason for termination and the right to continue seeing that provider for up to 90 days if the removal isn't due to fraud or misconduct. It mandates insurers to provide advance notice (60 days) to Maryland's Insurance Commissioner before terminating provider contracts that materially impact patient access, and to update their access plans within 5 business days after termination. This bill directly affects insured patients who rely on specific providers and health insurance carriers operating in Maryland. The key change is creating a standardized 90-day special enrollment period for affected patients to transition care, improving transparency during network changes.
HB 1364 requires mammography centers in Maryland to include a specific notice about breast arterial calcification in patients' screening results letters, starting October 1, 2026. This applies to facilities performing mammography testing (like hospitals, clinics, or radiology practices), excluding federal VA facilities. The notice informs patients that arterial calcification - common but potentially linked to higher cardiovascular risk - should be discussed with their physician to assess heart health needs. It does not change existing federal requirements for breast density notices but adds this new patient awareness element to standard mammogram results.
SB 890 exempts premiums for captive insurance purchased by nonprofit hospitals and healthcare systems in Maryland from the state's insurance premium receipts tax. Specifically, it removes the tax obligation for premiums paid by these entities, including their parent companies, subsidiaries, or affiliated providers. The bill also prohibits the Maryland Insurance Administration from charging past-due taxes, penalties, or interest related to this tax for qualifying entities before the law's effective date. This directly affects nonprofit healthcare organizations seeking cost savings on self-insurance arrangements. The policy change modifies existing tax code sections to create this specific exemption.
SB 808 amends Maryland's health insurance laws to change how health insurance carriers manage provider panels. It eliminates application fees carriers can charge providers, requires carriers to send specific notices to providers within set timeframes, and mandates more frequent updates to provider directories. The bill also expands the types of providers carriers cannot restrict on panels and updates rules for multi-carrier online directory systems. These changes directly affect health insurance carriers and healthcare providers seeking to join insurance networks.