Healthcare (Insurance)

in committee · Maryland · Senate Feb 12, 2026

SB 837: Maryland Medical Assistance Program and Health Insurance - Coverage and Utilization Review - Drugs Reviewed by the Prescription Drug Affordability Board

SB 837 prohibits Maryland insurance companies, health plans, and managed care organizations from requiring prior authorization, step therapy, or coverage restrictions for prescription drugs reviewed by the Prescription Drug Affordability Board (PDAB). It specifically blocks these requirements if the PDAB has not determined the drug causes an affordability challenge, has made a policy recommendation about it, or has set an upper payment limit. The bill directly affects patients needing covered medications and insurers that must comply with these new coverage rules. It aims to streamline access to PDAB-reviewed drugs by removing common insurance barriers without altering the drugs' clinical use.

Topics ✓ HealthcareSupports HealthcareProhibits prior authorization and step therapy for PDAB-reviewed drugs, improving patient access to prescribed medications without insurer barriers.95% confidence

Sub-Topics Insurance Prescription Drugs

Track

in committee · Maryland · House of Delegates Feb 11, 2026

HB 1114: HIV Prevention Drugs - Prescribing, Dispensing, and Insurance Coverage

HB 1114 allows pharmacists to prescribe and dispense HIV prevention drugs (PrEP) to patients under specific guidelines, expanding access beyond traditional doctor visits. It requires Maryland's Medicaid program (Medical Assistance Program) to cover FDA-approved HIV prevention drugs, including PrEP and PEP (post-exposure prophylaxis), starting January 1, 2027. The bill also prohibits insurers and managed care organizations from requiring prior authorization, step therapy, or cost-sharing for these medications. This directly affects pharmacists, Medicaid recipients, and health insurers by removing financial and administrative barriers to HIV prevention care. The policy aligns with CDC guidelines for PrEP and PEP use, ensuring coverage for medically appropriate HIV prevention drugs.

Topics ✓ HealthcareSupports HealthcareExpands access via pharmacists, mandates Medicaid coverage, and removes cost barriers for HIV prevention drugs, directly improving patient access and insurance coverage.95% confidence

Sub-Topics Insurance Medicaid

Track

died · Maryland · House of Delegates Mar 3, 2026

HB 1157: Health Insurance - Plan Benefits and Coverage - Annual Reporting (Transparency, Reporting, Understanding, Timeliness, and Honesty (TRUTH) in Mental Health Coverage Act)

HB 1157 requires health insurance carriers in Maryland to annually report detailed data on mental health and substance use coverage to the Insurance Commissioner using a standardized template. This data includes access to services by facility type (e.g., outpatient, inpatient), provider type (e.g., psychiatrists, psychologists), and demographics (e.g., youth vs. adult, in-person vs. telehealth), along with network accuracy and availability. The Commissioner must make this data publicly accessible via a website with interactive dashboards. The law directly affects all health insurance companies offering plans in Maryland, aiming to improve transparency about coverage gaps in mental health care.

Topics ✓ HealthcareSupports HealthcareRequires insurers to report mental health coverage data publicly, enhancing transparency and access to services, directly supporting mental health coverage standards.95% confidence

Sub-Topics Insurance Mental Health Telehealth

Track

in committee · Maryland · Senate Mar 6, 2026

SB 969: Health Insurance - Lyme Disease and Related Tick-Borne Illnesses - Long-Term Antibiotic Treatment

SB 969 requires Maryland health insurers, nonprofit health service plans, and health maintenance organizations to cover the full duration of long-term antibiotic treatment (over 4 weeks) for Lyme disease and related tick-borne illnesses when ordered by a licensed physician for treatment purposes. It prohibits these entities from imposing limits on treatment length or denying coverage solely because the treatment is labeled "unproven," "experimental," or "investigational." The law applies to all health insurance policies issued, delivered, or renewed in Maryland on or after January 1, 2027, directly affecting patients diagnosed with these conditions and their insurers. This ensures consistent coverage for extended antibiotic therapy without arbitrary restrictions based on treatment classification.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage for long-term Lyme treatment, prohibiting denials based on 'unproven' labels, expanding patient access to necessary care.95% confidence

Sub-Topics Insurance

Track

in committee · Maryland · House of Delegates Feb 16, 2026

HB 825: Brain Health - Guidelines, Grant Fund, and Commemorative Month (Tahjai's Law)

HB 825 (Tahjai's Law) requires Maryland's Governor to annually proclaim May as "Brain Health and Chronic Headache Awareness Month," aligning with national brain tumor awareness efforts. It establishes a permanent Maryland Brain Health Grant Fund to provide financial support to nonprofits, healthcare providers, and community programs for brain health awareness, screening, prevention, and services like treatment for brain tumors, chronic headaches, and traumatic brain injury. The Maryland Department of Health must develop guidelines for incorporating brain health evaluations into routine physical exams and recommend insurance coverage parity for necessary diagnostic tools. Additionally, the Department must submit annual reports on brain tumor prevalence, emergency visits related to brain conditions, access to diagnostic imaging, and barriers to care.

Topics ✓ HealthcareSupports HealthcareEstablishes permanent grant fund for brain health awareness, screening, prevention, and treatment services, directly funding healthcare initiatives.95% confidence

Sub-Topics Insurance

Track

died · Maryland · House of Delegates Mar 13, 2026

HB 1464: Health Insurance - Third-Party Administrators - Verification of Eligibility

HB 1464 requires health insurance companies (referred to as "carriers" or "third-party administrators") to create a simple, timely process for healthcare providers to verify if a patient is eligible for covered services before treatment. If a provider uses this process and receives confirmation of eligibility, the insurer cannot later retroactively deny payment for that service, even if the patient was ultimately ineligible. The bill also sets strict time limits for retroactive denials (6 months for most cases, 18 months for coordination with other insurers) and mandates written explanations for denials. This directly affects healthcare providers (like clinics and hospitals) and insurers in Maryland by reducing billing disputes and payment delays.

Topics ✓ HealthcareSupports HealthcarePrevents insurers from retroactively denying payments after eligibility verification, improving provider access to covered services.95% confidence

Sub-Topics Insurance

Track

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

HB 1013: Prince George’s County Special Education Service Delivery, Transparency, and Accountability Act

HB 1013 requires Prince George’s County Public Schools to fund full-time salaries and benefits (including health insurance) for all one-to-one student aides starting in the 2027-2028 school year. It mandates quarterly reports to the county board and state education department on key metrics like aide vacancy rates, IEP service delivery, and compensatory services completion. The bill also requires the county superintendent to provide annual professional development for special education staff and directs the state to hire a third-party auditor to review the county’s special education department for fiscal years 2021-2025. These provisions directly affect Prince George’s County’s special education program, its staff, and students with individualized education plans (IEPs).

Topics ✓ Budget & TaxesSupports Budget & TaxesMandates county funding for special education aides' salaries/benefits, increasing public service spending under fiscal management.95% confidence ✓ EducationSupports EducationMandates full-time aide funding, accountability reports, and staff development for special education, directly advancing K-12 special education services and support.95% confidence ✓ HealthcareSupports HealthcareBill explicitly requires health insurance as part of benefits for student aides, expanding health coverage for school staff.90% confidence ✓ Labor & EmploymentSupports Labor & EmploymentMandates full-time salaries, benefits (including health insurance), and professional development for special education aides, strengthening employment conditions and worker benefits.95% confidence

Sub-Topics Special Education Insurance

Track

signed · Maryland · House of Delegates May 26, 2026

HB 1118: Health, Health Insurance, and Health Occupations - Perinatal Behavioral Health Conditions

HB 1118 requires health insurance carriers in Maryland to provide a standing referral to a mental health care provider for pregnant individuals and for one year after childbirth, without needing a written treatment plan. It mandates that insurers cover screening for perinatal mental health conditions (like postpartum depression) during prenatal visits and other specified times. The bill also directs the Maryland Department of Health to establish a perinatal mental health screening program and requires health care professionals renewing licenses to complete continuing education on perinatal mental health conditions. These changes aim to improve access to mental health support during pregnancy and the postpartum period.

Topics ✓ HealthcareSupports HealthcareMandates insurer coverage of perinatal mental health screenings and standing referrals without barriers, expanding access to critical mental health services for pregnant/postpartum individuals.95% confidence

Sub-Topics Insurance Mental Health Public Health

signed · Maryland · Senate May 26, 2026

SB 890: Insurance - Captive Insurers - Premium Receipts Tax Study

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.

Topics ✓ Budget & TaxesSupports Budget & TaxesExempts nonprofit hospitals' captive insurance premiums from state tax, providing tax relief for essential healthcare entities.95% confidence ✓ HealthcareSupports HealthcareExempts nonprofit hospitals from insurance premium tax, reducing operational costs to support healthcare delivery and services.90% confidence

Sub-Topics Government Spending Insurance

signed · Maryland · Senate Apr 14, 2026

SB 910: Health Insurance - Graduate-Level Clinical Interns - Required Reimbursement

SB 910 requires Maryland health insurers to reimburse patients for services provided by graduate-level clinical interns in counseling, social work, and psychology, under specific conditions. This affects insured individuals who receive these services and insurers who must cover them. Key conditions include services being provided at outpatient facilities, interns being enrolled in accredited graduate programs, working under direct supervision of a licensed professional, and billed by the supervising provider. The bill amends existing insurance codes (Sections 15-704, 15-707, and 15-714) to add these reimbursement requirements for each profession’s interns.

Topics ✓ HealthcareSupports HealthcareMandates insurer reimbursement for mental health intern services, expanding coverage and improving access to counseling/psychology care under supervision.95% confidence

Sub-Topics Insurance