Maryland Legislation

This bill amends the Annotated Code of Maryland §15-802 to include in the definition of a “health benefit plan” short term limited duration insurance for the purposes of coverage requirements for the diagnosis and treatment of MH and SUD.

HB 599 and SB 631 amends section 15-802 by adding a new subsection to require insurers, nonprofit health service plans, or health maintenance organizations to use ASAM criteria for medical necessity and utilization management determinations for substance use disorder benefit claims.

This bill tried to change a section of the state Medicaid law so that substance use disorder treatment would no longer be covered by managed care organizations that cover medical care and primary mental health care but instead be covered by the payment system that covers specialty mental health care for Medicaid enrollees.

This bill tried to prohibit certain health insurers from making consumers with behavioral health conditions pay different copayments , deductibles , or coinsurance requirements for brand-name medication than what are in place for generic medications . Insurers would have been required to cover brand name prescription medication for mental illness if a similar generic medication has been ineffective or harmful to the person taking it.

This bill would have made delivery of the Maryland Medical Assistance Program line up with the Federal Parity Law and Maryland parity laws. The bill would have required the Department of Health and Mental Hygiene to use certain standards in determining compliance with the law. The bill would have required the Department of Health and Mental Hygiene to use certain criteria in determining medical necessity for substance use disorder services.

This bill would have required insurance plans to submit a report to the Maryland Insurance Commissioner certifying and outlining how certain plans comply with The Federal Parity Law and the state parity law. The report would have needed to include information on compliance with parity laws. The report would have been public record. The bill would have established penalties for certain violations.

This bill would have required insurers to submit to the Maryland Insurance Commissioner a yearly report outlining how the insurance plans they offer comply with the state parity law and Federal Parity Law . These reports would have included a list of covered and excluded behavioral health benefits as well as how any quantitative treatment limitations or non-quantitative treatment limitations are the same for behavioral health and other treatments.