House Bill 932 and Senate Bill 791 – Health Insurance – Utilization Review – Revisions
The bill takes effect July 1, 2024, and includes a number of key studies to assess the positive impacts of the bill and look at additional ways to eliminate administrative burdens.
Requiring evidence-based, peer-reviewed criteria as the standard of care developed by an organization that works directly with health care providers or a professional medical specialty society.
Mandates that a physician who made or participated in the adverse decision notify the insured’s physician or health care practitioner prior to making the adverse decision and be available to discuss the basis for the denial and the medical necessity of the health care service rather than deny care and then allow for a peer-to-peer meeting after the fact.
Creates a timeline for response by carriers for requests for services or extension of services within 1 working day.
Ensures timely reviews by including language to address private review agents who fail to respond to a request in the mandated amount of time, the requests will be deemed approved.
This was a consensus piece of legislation worked out by the broader healthcare provider community and health insurers that will streamline prior authorization requirements, make more transparent and interactive the decision-making processes employed by insurers and third-party administrators.
Maryland Medical Assistance Program and Health Insurance – Coverage for Prostheses (So Every Body Can Move Act) Requiring the Maryland Medical Assistance Program and certain insurers, nonprofit health service plans, and HMOs to provide certain coverage related to prostheses.
Start date: January 1, 2025
House Bill 1388 – Labor and Employment – Noncompete and Conflict of Interest Clauses for Veterinary and Health Care Professionals and Study of the Health Care Market The bill establishes prohibitions on the use of noncompete provisions by employers of patient facing licensed healthcare providers that earn less than $350,000 in total annual Compensation. For patient facing licensed healthcare providers who earn more than $350,000 in total annual compensation, any noncompete clause is limited to 1 year from the employees last day, and any geographic restriction cannot exceed a 10-mile radius from their primary place of employment. The bill includes a study of private equity in health care. The legislation is prospective only and will not take effect until July 1, 2025.
APTAMD members set our advocacy goals to sustain the profession, and ensure access to care for all Marylanders.
Join us in August for our annual legislative priority discussion and legislative prep. Your voice and involvement sets the advocacy agenda. This is a virtual event.
Date and time TBA
The Chapter Legislative Committee works with the Lobbyist Firm, Barbara Brocato and Associates, and the APTAMD Board of Directors. This committee is a resource for members to get answers to specific questions regarding legislation in Maryland. Advocacy and Legislation at a National level is handled by APTA.
If you would like to become more involved in legislative issues please check out our committee workspace.
As always there were a number of major pieces of healthcare legislation introduced this Session. We are proud to have worked firsthand on the development of successful legislation that will eliminate administrative burdens and barriers to care for all health care providers and their patients.
Scope of practice legislation was introduced across a number of specialties from Physician Assistants to Advanced Practice Nurses to cosmetologists and audiologists to name a few. We were involved in each of these fights, which the Legislature generally dislikes as well. We will be working over the interim and next Session to address the patient safety and quality of care concerns that were contemplated and, in some cases, enacted this Session.
Strides were made in the ongoing effort to address fair payment and reimbursement by regulated health insurers. Efforts to protect the State’s most vulnerable children through ensuring continuity of mental health care continued to advance as well.
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