Del. Anne Kaiser

Maddy summaryHB 848 requires Maryland health insurance carriers to submit quarterly reports to the Insurance Commissioner detailing adverse decisions (denials of coverage), including specific data on denied claims, grievance outcomes, and emergency case processing times. If a carrier’s adverse decisions for a specific service type rise by more than 10% annually or 25% over three years, they must also report the reasons for the increase, such as changes in medical management. The Commissioner will compile annual summary reports from this data and may use it to initiate examinations of carriers. This bill directly affects health insurance carriers operating in Maryland, aiming to increase transparency around coverage denials without altering coverage rules.

Maddy summaryHB 729 modifies Maryland's Overdose Response Program training requirements and clarifies restrictions on the Opioid Restitution Fund. It requires the Maryland Department of Health to emphasize "restoration of breathing" and "compassionate postoverdose support" in training on opioid overdose response, including administration of reversal drugs. The bill also explicitly restricts fund use to settlement agreement purposes, adding requirements to address racial disparities in access to prevention and treatment services. This directly affects the Department of Health's program administration and how the Opioid Restitution Fund - funded by opioid industry settlements - is allocated for evidence-based substance use disorder programs.

Maddy summaryHB 1351 requires health insurance carriers in Maryland to accept or reject applications from specific behavioral health professionals within 30 days of receiving a complete application. It directly affects licensed graduate social workers, counselors, therapists, and psychology associates who practice within their licensed scope, prohibiting carriers from rejecting them solely based on their license type. The bill shortens the decision timeline for clinical professionals (like Licensed Clinical Social Workers) to 30 days, compared to the previous 120-day window for others, and mandates written notice of decisions. Carriers failing to comply face penalties under Maryland insurance law. This change aims to streamline access to behavioral health services by reducing delays in provider panel enrollment.

Maddy summaryHB 1083 requires Maryland's Department of Health to convene a workgroup by December 2025 to create a plan implementing federal child behavioral health screening and treatment rules (EPSDT). The workgroup must include behavioral health professionals, childhood mental health specialists, parents/caregivers, children with behavioral health needs, and advocates. It will develop strategies for screening, using a specific diagnostic tool for children under 5, and expanding community-based services to address early symptoms, routine care, and crisis needs. The plan must align with federal best practices for children’s behavioral health care access. The department must submit the final plan to the legislature by December 1, 2025.

Maddy summaryHB 995 establishes a 15-member workgroup to study rising adverse decisions (like denied insurance claims or medical necessity denials) in Maryland's health care system. The workgroup, including state agency leaders, hospital representatives, insurers, and patient advocates, will review current reporting data and recommend standardized definitions, reporting methods, and processes to reduce such denials. It must submit findings and recommendations to legislative committees by December 1, 2025, with the bill expiring June 30, 2026. This is a procedural study mechanism with no immediate policy changes.

Maddy summaryHB 11 updates Maryland health insurance rules to improve access to nonparticipating health providers, particularly for mental health and substance use disorder services. The bill requires insurers to establish a referral process that helps members connect with specialists not on their provider panel when needed, and to provide additional assistance if standard referrals fail. It also prohibits insurers from demanding prior authorization for scheduling appointments with nonparticipating providers for these services. Additionally, the Maryland Health Care Commission must set reimbursement rates for nonparticipating providers to ensure fair payment. This directly affects health insurance carriers and their members seeking specialized care outside their network.

Maddy summaryHB 776 updates Maryland's laws regulating physicians, physician assistants, and allied health professionals by revising outdated or inconsistent language in the Medical Practice Act and Physician Assistants Act. The bill clarifies licensure requirements, disciplinary procedures, and reporting rules for these healthcare professionals, while also modifying grounds for discipline and administrative penalties. It affects licensed medical practitioners, the State Board of Physicians, and allied health advisory committees by streamlining regulatory processes. The bill focuses on administrative modernization rather than creating new policy, removing redundant provisions and aligning existing rules across the statutes.

Maddy summaryHB 334 establishes a statewide program requiring the Maryland Department of Health to provide universal newborn nurse home visiting services to all families with newborns (up to 12 weeks old) residing in Maryland. The program must be evidence-based, offered by licensed nurses, and delivered in homes or virtually, focusing on infant health, maternal well-being, family support, and child development. Crucially, the bill mandates that health insurers, nonprofit health plans, and health maintenance organizations cover and reimburse these services under existing policies. The program is voluntary for families, with no penalties for declining participation, and requires data collection on outcomes across key domains like reducing child maltreatment and improving school readiness.

Maddy summaryHB 1066 restructures Maryland's Commission on Behavioral Health Care Treatment and Access by expanding its membership from 19 to 48 members. It adds 29 new appointed members representing specific stakeholders, including consumers of behavioral health services, substance use treatment providers, housing specialists, and experts in areas like drug policy reform. The bill also requires the Commission to establish a dedicated workgroup focused on improving health, social, and economic outcomes related to substance use. This change directly affects the Commission's composition and operational structure, aiming to enhance diverse representation in behavioral health policy development.

Maddy summaryHB 820 requires health insurance companies, pharmacy benefits managers, and private review agents to follow specific rules when using artificial intelligence (AI) for medical coverage decisions (utilization review). It mandates that AI tools base decisions on individual patient medical records - not just group data - and cannot replace healthcare providers in review processes. The bill also prohibits AI from causing prohibited discrimination and requires insurers to report whether AI was used in denied claims. This directly affects insurers and review entities that use AI to approve or deny treatments, hospital stays, or medications.