Healthcare (Mental Health)

SB 490 prohibits Maryland's Medicaid program (Maryland Medical Assistance Program) from requiring prior authorization or step therapy protocols for prescription drugs treating specific serious mental illnesses. It directly affects Medicaid enrollees diagnosed with bipolar disorder, schizophrenia, major depression, PTSD, or medication-induced movement disorders linked to mental illness treatment. The law, effective July 1, 2026, removes barriers that previously forced doctors to seek approval before prescribing these medications or require trying less effective treatments first. The policy change applies only to these five conditions and expires automatically on June 30, 2029.

SB 39 establishes a workgroup to develop a sustainable reimbursement rate methodology for Maryland's Certified Community Behavioral Health Clinics (CCBHCs) and Outpatient Mental Health Centers (OMHCs), directly affecting behavioral health providers facing financial strain due to outdated rates. The bill requires the Maryland Department of Health to conduct a cost study of OMHC services, form an advisory panel to review rate recommendations, and increase Medicaid reimbursement rates for OMHCs in fiscal years 2026 and 2027. Key provisions include evaluating provider costs, workforce needs, and alignment with somatic health care parity, while addressing closures like those in Frederick County. The workgroup must report findings by December 2027, aiming to stabilize provider finances and ensure continued access to community mental health care.

SB 428 prohibits the Maryland Department of Health and certain insurers from charging copays, coinsurance, or deductibles for services delivered under the Collaborative Care Model. This model integrates mental/behavioral health services with primary care in clinics serving Medicaid recipients (Maryland Medical Assistance Program). The law applies to all health insurance plans (including nonprofit plans and health maintenance organizations) covering these services, with one exception: high-deductible health plans may still require deductibles for these services. The bill takes effect January 1, 2027, for new insurance policies and July 1, 2026, for the law itself.

SB 96 updates terminology in Maryland's Sheila E. Hixson Behavioral Health Services Matching Grant Program by removing the word "active" before "service member" throughout the law. This change clarifies that the program serves all service members (including those not currently on active duty), veterans, and their families, without altering eligibility criteria or funding. The bill specifically revises definitions in Section 7.5-210(a)(2)(i), (b)(2), and (e)(1)(ii) to replace "active service member" with "service member." It does not create new benefits or change who qualifies for grants, only how the program describes its target population. The change aims to align the law with the program's actual scope and improve clarity.

HB 498 removes an existing exemption that allowed intermediate care facilities providing substance use disorder treatment to change bed capacity without a certificate of need. It specifically targets facilities offering "medically managed residential substance use disorder treatment services," requiring them to file 45 days' written notice with the health commission before operating or expanding. The commission must then review and approve these changes based on whether they align with the state health plan, improve service efficiency, and serve the public interest. This bill directly affects facilities providing residential substance use treatment by adding a review process for bed capacity changes or new operations, replacing the previous exemption.

HB 280 codifies Maryland’s health insurance requirements for mental health and substance use disorder coverage to align with federal parity laws. It requires health insurers to collect and report data on access to these services, explain differences in coverage rules, and comply with federal standards for equal treatment. The Maryland Insurance Commissioner will review insurer reports and address noncompliance. This bill directly affects health insurance companies and their policyholders seeking mental health or substance use disorder care.

SB 326 expands the authority of physician assistants (PAs) in Maryland by allowing them to perform specific healthcare actions currently restricted to physicians. The bill directly affects PAs, patients requiring guardianship, inmates needing infirmary care, and mental health facilities by adding PAs to certification requirements for treatment incapacity (Section 5-606), guardianship petitions (Section 13-705), and inmate infirmary admissions (Section 9-601.1). It also requires the Maryland Department of Health to cover PA examinations for emergency evaluations and adds PAs to the Statewide Advisory Commission on Immunization. These changes aim to align PA practice with other licensed healthcare professionals in defined clinical scenarios.

HB 279 establishes a medication review committee within Maryland's Department of Public Safety to evaluate requests for involuntary psychotropic medication when an incarcerated individual refuses it, applying only to licensed mental health infirmaries in state correctional facilities. The bill prohibits administering such medication without committee approval, except in emergencies, and requires the committee to review medical records, consider less restrictive alternatives, and ensure the individual understands risks and benefits before a decision. Incarcerated individuals gain specific rights under the bill, including 10 business days' written notice of committee meetings, the right to attend (excluding closed deliberations), present information, and receive details about their diagnosis and treatment options. The committee, composed of appointed mental health professionals and a lay advisor, must document its rationale and follow defined procedures before authorizing medication against an individual's refusal.