MarylandHB 05292026 Regular SessionHouseWALLET

Code Revision - Health - Maryland Medical Assistance Program

Sponsored By: Sponsor information unavailable

Became Law

Public HealthAdvance Medical DirectivesAnnotated Code of MarylandChildren (4-12)ClinicsCodes -see also- Annotated Code of Md; Building CodesCommittees and CommissionsElectronic GovernmentEmergency Medical Services -see also- Ambul; RescSqdEthicsEvaluations and ReviewsHealth -see also- COVID19; EnvHlth; MedCon; etc.Health, Department ofHealth Insurance -see also- ACA; HMOs; MCOsLegislative Services, Department ofMedical AssistanceMental and Behavioral Health -see also- Aut; Cogn; Dev; etc.Penalties and Sentences -see also- Death PenaltyPharmacists and Pharmacies -see also- DrugsPovertyPublications -see also- Maryland Register; TextbooksPublic Benefits -see also- Housing; MedAsst; SupplNutrAsstPRecords -see also- Land Records; Vital RecordsReimbursementsRevenue and Taxes -see also- (specific tax)Rules and RegulationsStandards and Best PracticesStudentsSubstance Abuse TreatmentVulnerable Adults -see also- DevDisab; EldPers; PhysDisabYouth (10-21) -see also- Minors

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Bill Overview

Analyzed Economic Effects

13 provisions identified: 12 benefits, 0 costs, 1 mixed.

Medicaid now covers prosthetic devices

Starting January 1, 2025, Maryland Medicaid covers prosthetic devices as set in state law. Coverage follows Insurance Article § 15-844 and State budget limits. This lowers large out-of-pocket costs for people who need a prosthesis.

Abortion care covered for enrollees

Maryland Medicaid covers abortion care as set in state law. This lowers out-of-pocket costs when the coverage applies. Coverage depends on State budget limits.

Community violence prevention services covered

Starting July 1, 2023, Medicaid covers community violence prevention services when federal approval and State budget funds are in place. This reduces costs for people who receive these services.

Easier pediatric transfers and delivery coverage

Medicaid and the children's program cannot require prior authorization to transfer a child to a special pediatric hospital. Starting January 1, 2026, Medicaid covers transfers to a special pediatric hospital as set in law, subject to budget and federal rules. Also beginning January 1, 2026, if delivery anesthesia is covered, it must follow state coverage rules.

Faster access to PEP, contraception, pharmacists

MCOs cannot require prior authorization for HIV post‑exposure prophylaxis (PEP) when prescribed under CDC guidelines. The children's health program covers services by licensed pharmacists the same as other providers. It also cannot require prior authorization for FDA‑approved IUDs or implantable rods without an FDA black box warning; a prescription is required.

Faster enrollment and six-month coverage lock

By January 1, 2025, Maryland uses SNAP findings to enroll people into Medicaid and the children's program through Express Lane Eligibility. The program may guarantee up to 6 months of eligibility unless you get other health insurance. The Department or its contractor enrolls you into an MCO, gives a health risk assessment only after you pick a plan, and sends results to your MCO within 5 business days. These steps follow federal law and State budget limits.

Gender-affirming care covered by Medicaid

Starting January 1, 2024, Medicaid covers gender-affirming treatment as described in state law. Coverage is subject to the State budget. Check with your provider and plan on what is included.

Hepatitis C drugs covered when needed

Medicaid covers FDA‑approved, medically necessary hepatitis C drugs, no matter your fibrosis score. Coverage is subject to State budget limits.

Home blood pressure monitors are covered

Starting January 1, 2023, Medicaid covers self-measured blood pressure care for people with uncontrolled high blood pressure. Coverage includes a validated home monitor, training, data sharing, and related care. Budget limits and federal rules apply.

More dental care for adults and pregnant enrollees

Starting January 1, 2023, adults with income at or below 133% of the federal poverty level get Medicaid dental care. Covered care includes exams, cleanings, fillings, and gum treatment, subject to the State budget and federal rules. Plans cannot require more than 120 days between covered cleanings or oral exams in a plan year, starting January 1, 2022. Pregnant enrollees also get dental services as a required managed care benefit.

More SUD treatment for adults on cash aid

If you are 21 or older and get Temporary Cash Assistance, Medicaid covers inpatient, intermediate, and halfway‑house substance use disorder treatment. Your MCO must provide or arrange these services. Coverage follows federal law or waiver and State budget limits.

Stronger managed care rules and help

The Department can require enrollees to join managed care plans. MCO benefits must be at least what Medicaid required on January 1, 1996. MCOs must keep a strong quality program, pay for emergency services without prior authorization, and report service and outcome data, including semiannual substance use treatment counts and spending. The State sets actuarially adjusted MCO payments. The Department runs an ombudsman and a local hotline. School clinics must send encounter data to get paid, then are paid Medicaid rates. The Secretary may carve out services or groups, including dental, when allowed by federal law and the State budget.

Coverage for biomarker and heart tests

Starting July 1, 2025, Medicaid covers biomarker testing as set in state law. Starting January 1, 2026, it covers calcium score testing for heart risk. Both depend on State budget limits and federal rules.

Sponsors & Cosponsors

Cosponsors

There are no cosponsors for this bill.

Roll Call Votes

All Roll Calls

Yes: 181 • No: 1

Senate vote • 4/6/2026

Third Reading Passed

Yes: 46 • No: 0

House vote • 2/26/2026