Maryland Medical Assistance Program, Maryland Children’s Health Program, and Health Insurance – Transfers to Special Pediatric Hospitals – Prior Authorizations

HB 1301 prohibits the Maryland Medical Assistance Program, Maryland Children’s Health Program, managed care organizations, and certain health insurers from requiring prior authorization for transfers to special pediatric hospitals. The bill defines "special pediatric hospitals" as facilities providing nonacute medical, rehabilitation, therapy, and palliative care to individuals under 22 years old, or those aged 2-22 with co-occurring physical and behavioral health conditions. It amends Maryland law to require coverage for such transfers without prior approval, effective January 1, 2026. This directly affects Medicaid programs, children’s health programs, and health insurers covering hospital or medical services in Maryland.