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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.

MCO plans follow same insurance rules

Beginning January 1, 2026, Medicaid managed care plans must follow the same state insurance rules as other carriers. This includes how they handle prior authorization and medical-necessity decisions for transfers to special pediatric hospitals.

Medicaid and CHIP cover pediatric transfers

Beginning January 1, 2026, Medicaid and CHIP cover transfers to special pediatric hospitals. For these transfers, the programs do not require prior authorization. If the hospital asks, they must issue a decision within 2 to 3 business days. A special pediatric hospital is in Maryland and provides non-acute medical, rehab, therapy, or palliative care. It serves people under 22, and ages 2 through 22 with both physical and behavioral health conditions.

Review past denials for pediatric hospitals

By December 31, 2026, the Maryland Department of Health adopts rules to review past denials for special pediatric hospitals. Hospitals or referring providers can ask for a peer-to-peer reconsideration when a transfer or service was denied as not medically necessary. The review covers denials of admission or payment for services on or after January 1, 2025. A licensed physician conducts the review. During the review, the reviewing entity must pay for all administrative days at the set rate from the denial date until the review ends.

Sponsors & Cosponsors

Sponsor

  • Samuel I. Rosenberg

    Democratic • House

Cosponsors

  • Tiffany T. Alston

    Democratic • House

  • Heather Bagnall

    Democratic • House

  • Bonnie Cullison

    Democratic • House

  • Pam Lanman Guzzone

    Democratic • House

  • 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

  • Matthew Morgan

    Republican • House

  • Ashanti Martinez

    Democratic • 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

Senate vote • 4/9/2026

Third Reading Passed

Yes: 43 • No: 0 • Other: 1

House vote • 4/9/2026

Third Reading Passed

Yes: 131 • No: 2 • Other: 3

House vote • 3/23/2026

Third Reading Passed

Yes: 134 • No: 2 • Other: 4

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

  • Enacted

    4/28/2026

    PDF

  • Enrolled

    4/9/2026

    PDF

  • Third Reading

    3/23/2026

    PDF

  • First Reading

    2/13/2026

    PDF

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