Healthcare (Medicaid)

died · Maryland · House of Delegates Mar 13, 2026

HB 1440: Maryland Medical Assistance Program and Health Insurance - Coverage and Utilization Review - Drugs Reviewed by the Prescription Drug Affordability Board

HB 1440 prevents Medicaid plans and certain health insurers from requiring extra approval steps (like prior authorization) or limiting coverage for prescription drugs reviewed by Maryland's Prescription Drug Affordability Board (PDAB). It specifically applies when the PDAB hasn't determined a drug causes cost concerns, has made a policy recommendation, or set a payment limit for the drug. This directly affects patients using these medications by reducing barriers to accessing covered drugs. The bill updates Maryland's health insurance and Medicaid laws to enforce these restrictions on managed care organizations and insurers.

Topics ✓ HealthcareSupports HealthcarePrevents prior authorization barriers for PDAB-reviewed drugs, improving patient access to covered medications without cost concerns or policy limits.92% confidence

Sub-Topics Insurance Medicaid Prescription Drugs

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in committee · Maryland · Senate Feb 13, 2026

SB 963: Maryland Department of Health - Medicaid Management Information System - Mainframe System Replacement

This bill requires Maryland's Department of Health to replace its outdated Medicaid mainframe system with a modern, modular system by 2028. The new system must maintain all current Medicaid functions - including provider enrollment, claims processing, and data reporting - while improving security, accuracy, and performance. The Department must integrate the replacement with the Medicaid Enterprise System by January 2027 and fully transition all applications from the old system by January 2028, decommissioning the legacy system afterward. This change directly affects the Department’s internal operations, not Medicaid beneficiaries or providers, and aligns with federal requirements for Medicaid IT systems.

Topics ✓ HealthcareSupports HealthcareBill modernizes Medicaid IT infrastructure to maintain/upgrade critical healthcare functions (claims processing, enrollment), improving system security and performance for Medicaid services.92% confidence ✓ TechnologySupports TechnologyBill mandates modern system replacement with explicit focus on improving security, accuracy, and performance for Medicaid data processing, directly enhancing cybersecurity infrastructure.92% confidence

Sub-Topics Medicaid

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in committee · Maryland · House of Delegates Mar 17, 2026

HB 1597: Health - Unregulated Space in Hospital Operating Suites - Pilot Project

HB 1597 establishes a 3-year pilot project (2026-2029) allowing up to five Maryland hospitals to create unregulated operating room space within regulated facilities. Participating hospitals must follow specific criteria: maintain charity care, charge comparable rates to regulated services, reduce costs for Medicaid/Medicare, and avoid duplicating services in regulated spaces. The Health Services Cost Review Commission administers the pilot, requires annual reports on procedures, costs, and impacts on healthcare efficiency, and mandates data sharing from associated surgical centers. This directly affects participating hospitals, patients using unregulated space, and payers (including Medicaid/Medicare), with no changes to existing regulated hospital services.

Topics ✓ HealthcareSupports HealthcareReduces costs for Medicaid/Medicare while maintaining charity care and avoiding duplication, improving access and affordability within healthcare delivery.85% confidence

Sub-Topics Hospitals Medicaid Medicare

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passed · Maryland · House of Delegates Apr 13, 2026

HB 1445: Maryland Medical Assistance Program and Developmental Disabilities Administration - Home- and Community-Based Services Eligibility Determinations (Maryland Protecting People With Disabilities Act)

HB 1445, the "Maryland Protecting People With Disabilities Act," changes eligibility rules for home- and community-based services under Maryland's Medicaid program (Maryland Medical Assistance Program). It requires the state to continue services uninterrupted during appeals if an individual loses eligibility, prohibits automatic termination solely due to administrative errors (procedural disenrollment), and mandates data sharing between providers and the Department of Health. The bill directly affects people receiving Developmental Disabilities Administration services and Medicaid beneficiaries who risk losing community-based care due to eligibility disputes. Key provisions include extending appeal timelines (replacing 90-day deadlines with continuous service until appeal resolution) and requiring the state to reserve waiver slots for those who lost eligibility unfairly. These changes aim to align with the Olmstead v. L.C. Supreme Court ruling protecting community integration rights.

Topics ✓ HealthcareSupports HealthcarePrevents administrative termination of Medicaid services during appeals and ensures uninterrupted access to home/community-based healthcare for disabled individuals, directly protecting patient access.95% confidence

Sub-Topics Medicaid Tags People with Disabilities

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

HB 1291: Public Health - Maryland Medical Assistance Program - Continuity of Care

HB 1291 requires the Maryland Department of Health to create procedures ensuring seniors aged 65+ who received in-home services within the past six months can temporarily continue care during service lapses caused by departmental errors. The bill mandates that temporary service continuation (up to 52 days or 1,248 hours) begin immediately upon service interruption and cover only previously approved services. It prohibits the department from altering existing appeal rights or billing recipients for services provided during this temporary period. The law applies specifically to seniors facing administrative or technical errors in their Medicaid coverage, ensuring uninterrupted care without financial burden. The bill takes effect October 1, 2026.

Topics ✓ HealthcareSupports HealthcareEnsures continuity of in-home care for seniors during service lapses, protecting access to approved services without billing recipients or altering appeal rights.95% confidence

Sub-Topics Long-Term Care Medicaid Public Health

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signed · Maryland · House of Delegates May 26, 2026

HB 746: Maryland Medical Assistance Program and Health Insurance - Collaborative Care Model - Cost Sharing Prohibition and Coverage Requirements

HB 746 prohibits Maryland Medicaid (Medical Assistance Program) and private health insurers from charging copays, coinsurance, or deductibles for services delivered under the Collaborative Care Model. This model integrates mental/behavioral health services into primary care through coordinated care, regular outcome monitoring, and specialist consultations. The law applies to all Medicaid recipients and covers services under private health insurance plans (including nonprofit health plans and health maintenance organizations) issued in Maryland, with an exception for high-deductible health plans. It takes effect January 1, 2027, ensuring no cost-sharing for these integrated care services.

Topics ✓ HealthcareSupports HealthcareProhibits cost-sharing for integrated mental health services under Collaborative Care Model, improving access to behavioral health within primary care for Medicaid and private insurance holders.95% confidence

Sub-Topics Insurance Medicaid Mental Health

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

HB 1264: Public Health - Maryland Medical Assistance Program - Tobacco Cessation

HB 1264 requires Maryland's Medical Assistance Program (Medicaid for low-income residents) to cover individual and group counseling for tobacco cessation, subject to state budget and federal law limits. It prohibits the program and managed care organizations from demanding prior authorization for any tobacco cessation product or service. This bill directly affects Medicaid beneficiaries seeking to quit tobacco use and their healthcare providers. The law amends existing Maryland health code sections to implement these coverage requirements and remove authorization barriers.

Topics ✓ HealthcareSupports HealthcareExpands Medicaid coverage for tobacco cessation counseling without prior authorization, improving access to public health services and aligning with healthcare access indicators.95% confidence

Sub-Topics Medicaid Public Health

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in committee · Maryland · House of Delegates Mar 3, 2026

HB 1246: Maryland Department of Health - Employment Training and Opportunity Database

HB 1246 requires the Maryland Department of Health to create and maintain a public database listing job training and employment programs across the state. This database will help individuals qualify for or maintain eligibility for Maryland Medical Assistance (Medicaid) and Supplemental Nutrition Assistance Program (SNAP) benefits by connecting them directly to relevant training opportunities. Key provisions include monthly updates to the database, coordination with agencies like the Department of Labor and Human Services to recommend programs, and a direct contact mechanism for users to enroll in listed programs. The bill aims to streamline access to workforce development resources for residents seeking to improve their economic stability while qualifying for state assistance programs.

Topics ✓ HealthcareSupports HealthcareBill connects job training to Medicaid/SNAP eligibility, improving access to healthcare benefits by maintaining program eligibility through employment opportunities.95% confidence ✓ Labor & EmploymentSupports Labor & EmploymentBill creates database linking job training to Medicaid/SNAP eligibility, advancing employment access and workforce opportunities.85% confidence

Sub-Topics Medicaid Workforce Development

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passed both · Maryland · House of Delegates Apr 9, 2026

HB 813: Maryland Medical Assistance Program - Coverage for the Treatment of Obesity - Authorization

HB 813 authorizes Maryland's Medicaid program (Maryland Medical Assistance Program) to cover comprehensive obesity treatment, including intensive behavioral therapy, bariatric surgery, and FDA-approved weight management medications, starting January 1, 2027. The bill requires the Maryland Department of Health to notify Medicaid recipients if it chooses to provide this coverage and mandates a report to the legislature by November 1, 2027, on implementation progress. This directly affects Medicaid recipients with obesity by expanding covered treatments beyond current scope. The program may use standard utilization management processes (like for other conditions) to assess medical necessity but is not required to offer the coverage.

Topics ✓ Budget & TaxesSupports Budget & TaxesAuthorizes Medicaid expansion for obesity treatment, requiring state budget allocation for new coverage starting 2027, aligning with funding essential health programs.95% confidence ✓ HealthcareSupports HealthcareBill authorizes Medicaid coverage for obesity treatment (behavioral therapy, surgery, medications), expanding healthcare access and funding for a critical health condition.95% confidence

Sub-Topics Medicaid

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passed · Maryland · Senate Mar 25, 2026

SB 608: Maryland Medical Assistance Plan and Health Insurance - Pharmacogenomic Testing - Required Coverage

SB 608 requires Maryland's Medicaid program (Maryland Medical Assistance Plan) and certain health insurers, nonprofit health plans, and health maintenance organizations to cover single-gene and multigene pharmacogenomic testing starting July 1, 2027. This applies specifically when a treating provider orders the test for patients with depression or anxiety who are considering a medication change, dose adjustment, or addition with a known gene-drug interaction. The bill limits prior authorization requirements to ensure timely access, mandating clear pathways, minimal documentation, and sufficient time for submissions without creating unnecessary delays. Noncompliance could result in penalties of up to $10,000 per violation plus $1,000 daily until resolved. The law aims to improve medication safety and effectiveness by making this genetic testing accessible for targeted patient groups.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid/insurers to cover pharmacogenomic testing for depression/anxiety treatment adjustments, expanding access to personalized mental health care without prior authorization barriers.95% confidence

Sub-Topics Insurance Medicaid

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