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MarylandHB 13762026 Regular SessionHouseWALLET

Maryland Medical Assistance Program, Maryland Children's Health Program, and Health Insurance - Transfers to Special Pediatric Hospitals - Requirements

Sponsored By: Samuel I. Rosenberg (Democratic)

Signed by Governor

Health - InsurancePublic HealthHealth Maintenance OrganizationsChildren (4-12)Evaluations and ReviewsHealth -see also- COVID19; EnvHlth; MedCon; etc.Health, Department ofHealth Insurance -see also- ACA; HMOs; MCOsHealth Maintenance Organizations -see also- Manage Care OrgsHospitals -see also- Clinics; State HospitalsManaged Care Organizations -see also- Health Maint OrgsMedical AssistanceNonprofit OrganizationsPhysicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.ReimbursementsRules and RegulationsTime

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 3 benefits, 0 costs, 0 mixed.

Faster Medicaid transfers to pediatric hospitals

Beginning January 1, 2026, Medicaid and MCHP cover transfers to special pediatric hospitals. They cannot require prior authorization for a transfer. If a hospital or referring provider asks, Medicaid gives a decision within 3 business days. Managed care organizations must follow the same rules starting January 1, 2026. A special pediatric hospital serves people under 22, and ages 2 to under 23 with both physical and behavioral health needs.

Private plans speed pediatric hospital transfers

For plans issued, delivered, or renewed on or after January 1, 2027, insurers cannot require prior authorization for transfers to special pediatric hospitals. If the hospital or referring provider asks, insurers must decide within 3 business days. If a transfer is denied as not medically necessary, the insurer must do a retrospective review on request, even if the family gets no money. While the review is pending, the hospital or provider is paid for all administrative days from the decision date.

Stronger Medicaid appeals and interim pay

The Health Department must set a retrospective review process by December 31, 2026. Reviews are by a licensed doctor and allow peer‑to‑peer reconsideration. Reviews cover denials of admission or payment on or after January 1, 2025. Medicaid must do the review even if the enrollee does not gain money. While the review is pending, the hospital or provider is paid for all administrative days from the decision date.

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Sponsors & Cosponsors

Sponsor

  • Samuel I. Rosenberg

    Democratic • House

Cosponsors

  • Tiffany T. Alston

    Democratic • House

  • Heather Bagnall

    Democratic • House

  • Bonnie Cullison

    Democratic • House

  • Guy Guzzone

    Democratic • Senate

  • Terri L. Hill

    Democratic • House

  • Thomas S. Hutchinson

    Republican • House

  • Aaron M. Kaufman

    Democratic • House

  • Nicholaus R. Kipke

    Republican • House

  • Lesley J. Lopez

    Democratic • House

  • Todd B. Morgan

    Republican • House

  • Ashanti Martinez

    House

  • Teresa E. Reilly

    Republican • House

  • Kim Ross

    Democratic • House

  • Kathy Szeliga

    Republican • House

  • Jennifer White Holland

    Democratic • House

  • Teresa Woorman

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 308 • No: 4

House vote • 4/9/2026

Third Reading Passed

Yes: 131 • No: 2 • Other: 8

Senate vote • 4/9/2026

Third Reading Passed

Yes: 43 • No: 0 • Other: 3

House vote • 3/23/2026

Third Reading Passed

Yes: 134 • No: 2 • Other: 6

Actions Timeline

  1. Approved by the Governor - Chapter 325

    4/28/2026

  2. Passed Enrolled

    4/9/2026House

  3. Third Reading Passed (131-2)

    4/9/2026House

  4. House Concurs Senate Amendments

    4/9/2026House

  5. Third Reading Passed (43-0)

    4/9/2026Senate

  6. Second Reading Passed with Amendments

    4/8/2026Senate

  7. Favorable with Amendments {943321/1 Adopted

    4/8/2026Senate

  8. Favorable with Amendments Report by Finance

    4/8/2026Senate

  9. Hearing 3/31 at 1:00 p.m.

    3/25/2026Senate

  10. Referred Finance

    3/23/2026Senate

  11. Third Reading Passed (134-2)

    3/23/2026House

  12. Second Reading Passed with Amendments

    3/23/2026House

  13. Favorable with Amendments {603328/1 Adopted

    3/23/2026House

  14. Favorable with Amendments Report by Health

    3/23/2026House

  15. Hearing 3/05 at 1:00 p.m.

    2/13/2026House

  16. First Reading Health

    2/13/2026House

Bill Text

  • Enrolled

    4/9/2026

    PDF

  • Third Reading

    3/23/2026

    PDF

  • First Reading

    2/13/2026

    PDF

Related Bills

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