HB 1167 requires Maryland's Department of Health to replace its outdated Medicaid computer system with a modern, flexible system by 2028. The new system must maintain all current Medicaid functions - including processing medical/dental/pharmacy claims, provider enrollment, and beneficiary inquiries - while meeting federal security and performance standards. The bill mandates integration with existing Medicaid systems by January 2027 and full replacement of the old system by January 2028, subject to federal approval. This change directly affects Medicaid beneficiaries and healthcare providers through more reliable service delivery.
HB 808 prohibits Maryland's Medicaid program (Medical Assistance Program) from requiring prior authorization or step therapy/fail-first protocols for prescription drugs treating five specific serious mental health conditions: bipolar disorder, schizophrenia, major depression, PTSD, or medication-induced movement disorders linked to mental illness treatment. Starting July 1, 2026, the program must cover these medications without extra approval steps for adult enrollees diagnosed with these conditions. The law applies only to Medicaid-covered drugs for these diagnoses and expires on June 30, 2029. This directly affects Medicaid enrollees with these diagnoses by reducing administrative barriers to accessing prescribed mental health medications.
HB 1002 prohibits nursing facilities from involuntarily discharging or transferring residents to temporary housing (like hotels) without confirmation from the receiving facility that it can accept the resident. It requires facilities to provide residents with clear written notices at least 10 days before a discharge or transfer, including the reason, new location, and contact information for hearings. The bill also bans facilities from discharging Medicaid-eligible residents solely because they qualify for Medicaid benefits, and mandates that post-discharge plans include specific care details. These changes aim to protect residents' rights and ensure smoother transitions during involuntary moves.
SB 742, the "Maryland Protecting People With Disabilities Act," modifies Maryland’s Medicaid eligibility processes to better protect individuals with disabilities who receive home- and community-based services. It extends the appeal timeframe for those losing eligibility and requires services to continue uninterrupted during appeals, preventing administrative errors from causing abrupt service loss. The bill prohibits "procedural disenrollment" (terminating coverage due to renewal process issues) and mandates the Department of Health to reserve waiver slots for people who lost eligibility unfairly. These changes align with the Olmstead decision, ensuring individuals can remain in community settings without unnecessary bureaucratic barriers. The bill directly affects Maryland Medicaid recipients with disabilities who rely on home- and community-based services.
Sub-Topics
Medicaid
Tags
People with Disabilities
SB 798 requires Maryland’s Medical Assistance Program (Medicaid) to cover individual and group counseling for tobacco cessation, starting October 1, 2026, subject to state budget and federal law. It directly affects Medicaid enrollees seeking to quit tobacco use by eliminating prior authorization requirements for cessation counseling and related products. The bill amends program rules to mandate this coverage under Section 15-103(a)(2)(xxix) and prohibits managed care organizations from blocking access to these services via prior approval. This policy change aims to remove administrative barriers to evidence-based tobacco cessation support for low-income Maryland residents.
SB 738 requires Maryland's Medicaid program (Medical Assistance Program) and certain health insurance plans to cover mobile crisis and crisis stabilization services starting January 1, 2027. These services provide immediate in-person mental health crisis assessment, de-escalation, and stabilization for individuals experiencing acute mental health emergencies. The law applies to Medicaid recipients and individuals covered under specified health insurance policies, including nonprofit health plans, HMOs, and managed care organizations. It mandates coverage without additional patient cost-sharing for these services, effective for all new or renewed health plans on or after the start date.
HB 1414 requires Maryland nursing homes to spend at least 75% of their nursing and residential care revenue on direct care staff wages and benefits, including nurses, dietary workers, and therapists. It also mandates that nursing homes submit detailed annual cost reports by September 1 (starting in 2027) to the Maryland Department of Health, including proof of wage payments and other required data. Failure to comply could lead to enforcement actions such as corrective plans or suspension from the Maryland Medicaid program. The bill directly affects all nursing homes operating in Maryland and takes effect October 1, 2026.
HB 1331 requires Maryland’s Department of Health and Department of Human Services to verify eligibility for public benefits (like Medicaid) through automated data-sharing with federal and state agencies, replacing self-attestation. It mandates monthly reviews of death records, incarceration, and address changes, and quarterly checks of tax filings, employment, and income data to ensure ongoing eligibility. The bill prohibits providing benefits to non-citizens, requires annual inspections of retail facilities for certain programs, and establishes new work requirement compliance reviews. These changes directly affect individuals applying for or receiving public assistance by shifting verification from self-reported information to cross-checked data.
SB 493 prohibits nursing facilities in Maryland from involuntarily discharging or transferring residents except for specific reasons like the resident's welfare, health improvement, or facility closure. It requires facilities to provide residents with a clear written notice at least 10 days before any involuntary discharge or transfer, detailing the reason, new location, and contact information for hearings and legal assistance. The bill also bans sending residents to temporary housing (like hotels) without confirmation from the receiving facility and prevents facilities from discharging Medicaid-eligible residents solely because they qualify for Medicaid. These changes aim to protect vulnerable residents by ensuring proper notice, preventing unfair treatment, and requiring confirmation before transfers.
HB 1107 (Healing Our Scars Act) requires Maryland Medicaid and specific health insurers (including nonprofit health plans, HMOs, and managed care organizations) to cover aesthetic services and restorative care for scars resulting from domestic violence injuries, starting January 1, 2027. This applies only to services deemed medically necessary by a licensed physician to treat physical injuries caused by domestic violence, as defined under Maryland Family Law. The law mandates this coverage for all policies issued or renewed in Maryland on or after the effective date. It does not expand eligibility for Medicaid but adds a specific coverage requirement for victims of domestic violence.
