Healthcare

signed · Maryland · Senate May 26, 2026

SB 521: Health Insurance - Material Changes to Provider Networks - Notification and Special Enrollment Period

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.

Topics ✓ HealthcareSupports HealthcareRequires insurers to notify patients of provider removal and allow 90-day continuation, improving patient access and protecting rights in health insurance networks.95% confidence

Sub-Topics Insurance Mental Health Primary Care

passed · Maryland · House of Delegates Apr 9, 2026

HB 1014: Mental Health Law - Danger to the Life or Safety of the Individual or of Others - Definition (Right to Treatment)

HB 1014 defines "danger to the life or safety of the individual or of others" for Maryland's mental health law, directly affecting individuals with mental disorders who might face involuntary admission. It specifies four concrete scenarios that constitute this danger: causing bodily harm, engaging in conduct leading to criminal involvement, inability to meet basic needs (food, shelter, medical care), or substantial deterioration in judgment that impairs treatment decisions. The definition requires a "substantial risk" considering the person's current condition and available history, replacing the prior standard. This change clarifies the legal threshold for involuntary hospitalization and emergency evaluations under Maryland law.

Topics ✓ HealthcareSupports HealthcareDefines clear criteria for involuntary mental health admission, preventing arbitrary detention and protecting patient rights under mental health law.85% confidence

Sub-Topics Mental Health

Track

signed · Maryland · House of Delegates May 26, 2026

HB 1093: Health Insurance - Provider Panels - Requirements

HB 1093 requires health insurance companies (carriers) to change how they manage provider panels. It removes application fees for providers seeking panel inclusion, mandates specific notice timelines for denials, and requires carriers to update provider directories more frequently. The bill also expands the types of providers carriers cannot restrict (like mental health specialists) and changes rules for reimbursing patients for care from nonparticipating providers. These changes directly affect health insurance companies, doctors/hospitals seeking panel access, and patients navigating provider networks.

Topics ✓ HealthcareSupports HealthcareRemoves provider application fees, expands mental health specialist access, mandates timely denials and updated directories, improving patient access to care.95% confidence

Sub-Topics Insurance Mental Health

in committee · Maryland · Senate Feb 12, 2026

SB 797: Maryland Medical Assistance Program and Health Insurance - Claims for Reimbursement - Downcoding

SB 797 prohibits insurers, nonprofit health service plans, HMOs, and managed care organizations from downcoding healthcare claims (reducing reimbursement without proper justification) in specific situations. The bill requires these entities to provide healthcare providers with a 30-day notice before downcoding, including the specific reason, original and revised codes, and an opportunity to submit additional documentation. It bans practices like using algorithms without clinical review, downcoding based solely on diagnosis codes, or targeting providers treating complex conditions. This directly affects healthcare providers and insurers by establishing clear rules for claim reimbursement and appeal processes.

Topics ✓ HealthcareSupports HealthcareProhibits unjust insurer downcoding, requiring notice and justification to protect provider reimbursement and ensure patient access to care.95% confidence

Sub-Topics Insurance

Track

in committee · Maryland · House of Delegates Feb 13, 2026

HB 1385: Health Insurance - Use of Artificial Intelligence - Human Evaluation

HB 1385 requires health insurers and pharmacy benefit managers using artificial intelligence (AI) for medical treatment reviews (utilization review) to include licensed healthcare professionals in key evaluations. Specifically, it mandates that AI decisions must be reviewed by a licensed professional who can question, modify, or override AI determinations based on a patient’s full medical history and individual circumstances. The bill also requires quarterly reviews of AI performance using human assessments of real-world health outcomes to improve accuracy and safety. These provisions apply to all AI tools used in utilization review processes within Maryland’s health insurance system, effective October 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates human evaluation of AI medical decisions to ensure patient-specific care and protect patient rights in insurance coverage.95% confidence ✓ TechnologySupports TechnologyMandates human oversight for AI in healthcare decisions, ensuring patient safety and regulatory compliance per consumer protection indicators.85% confidence

Sub-Topics Insurance Prescription Drugs Artificial Intelligence

Track

in committee · Maryland · Senate Feb 12, 2026

SB 779: Better Small Business Employee Benefit Act of 2026

SB 779 exempts professional employer organizations (PEOs) from certain health benefit plan requirements when offering coverage to small employers in Maryland. It directly affects small businesses that use PEOs for employee benefits and the PEOs themselves. The bill requires PEOs to provide written disclosure of plan details to small employers before offering coverage, while removing the need for PEOs to comply with standard health plan mandates like offering plans through the Maryland Health Benefit Exchange. This change simplifies access to health benefits for small employers using PEOs.

Topics ✗ HealthcareOpposes HealthcareExempts PEOs from health plan mandates, reducing required coverage standards for small business employees. This restricts comprehensive benefits per bill language.85% confidence ✗ Labor & EmploymentOpposes Labor & EmploymentRemoves standard health plan mandates protecting worker benefits, weakening employer requirements for PEOs in small business health coverage.85% confidence

Sub-Topics Insurance Tags Small Business

Track

in committee · Maryland · House of Delegates Feb 13, 2026

HB 1134: Pharmaceutical Drugs and Devices - Gifts to Health Care Professionals - Prohibition

HB 1134 prohibits pharmaceutical and medical device sellers from giving healthcare professionals gifts exceeding $50 in total retail value per calendar year. It directly affects drug/device manufacturers and healthcare professionals who prescribe or recommend products, including their organizations and employees. The bill defines "gifts" broadly to include payments, food, travel, and entertainment (excluding peer-reviewed medical literature) and sets a clear annual $50 limit. Violations are punishable as misdemeanors with fines up to $5,000 or six months in jail. The law takes effect October 1, 2026.

Topics ✓ HealthcareSupports HealthcareProhibits drug makers from giving gifts to healthcare pros to prevent conflicts of interest, protecting patient care integrity and aligning with patient rights protection.90% confidence

Track

in committee · Maryland · House of Delegates Feb 19, 2026

HB 739: Health Insurance - Prompt Payment of Claims - Requirements

HB 739 requires health insurers, nonprofit health plans, and HMOs to pay or clearly explain claim refusals within 30 days of receiving a claim. It mandates that insurers provide specific, detailed notices when denying payment (including exact missing information) and treats any refusal as an official denial. The bill also limits fees for electronic payments (e.g., credit card) by requiring advance notice to providers and offering fee-free alternatives, while extending the time providers have to submit claims (180 days) and appeal denials (90 days). This directly affects insurers and providers by standardizing payment timelines and reducing opaque claim denials.

Topics ✓ HealthcareSupports HealthcareMandates timely insurer payments and clear denial explanations, improving provider access and reducing claim disputes in healthcare insurance processing.95% confidence

Sub-Topics Insurance

Track

in committee · Maryland · House of Delegates Feb 19, 2026

HB 865: Health Insurance - Remittance Advice - Interest on Late-Paid Claims

HB 865 requires health insurers, nonprofit health service plans, and health maintenance organizations (HMOs) to provide clear remittance advice that separately identifies and itemizes interest owed on late-paid claims. Specifically, it mandates that interest rates apply at 1.5% for claims unpaid 31-60 days, 2% for 61-120 days, and 2.5% after 120 days. This interest is automatically included in the reimbursement payment without requiring claim filers to submit additional claims for the interest. The bill directly affects insurers and the healthcare providers or patients who file claims, ensuring transparency in late-payment calculations. It takes effect October 1, 2026.

Topics ✓ HealthcareSupports HealthcareMandates insurers pay interest on late claims, ensuring timely reimbursement for healthcare providers and strengthening financial stability in healthcare services.90% confidence

Sub-Topics Insurance

Track

signed · Maryland · House of Delegates May 26, 2026

HB 882: Consumer Health Information - Termination Date and Mandatory Funding for the State's Consumer Health Information Hub - Repeal

HB 882 repeals the requirement that the Governor must include a mandatory $350,000 annual appropriation for the State's Consumer Health Information Hub in the budget. It also removes the automatic expiration date (June 30, 2026) for the Hub's funding provisions. The bill changes the Hub's mandate to carry out its duties "to the extent funding is available," meaning its operations now depend on annual budget decisions rather than guaranteed funding. This directly affects the Hub - designated as the University of Maryland Herschel S. Horowitz Center for Health Literacy - by eliminating its guaranteed funding stream and making its services subject to yearly budget approvals.

Topics ✗ Budget & TaxesOpposes Budget & TaxesRepeals mandatory $350k annual funding, making Hub operations dependent on annual budget approval instead of guaranteed support. Defunds essential program by removing automatic appropriation.90% confidence ✗ HealthcareOpposes HealthcareRepeals mandatory $350k annual funding, making Hub operations dependent on annual budget approvals rather than guaranteed support.95% confidence

Sub-Topics Appropriations