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MarylandHB 15632026 Regular SessionHouseWALLET

Emergency Room Services and Post-Acute Care - Coverage and Facility Studies

Sponsored By: Harry Bhandari (Democratic)

Signed by Governor

Public HealthHealth Care Facilities and RegulationHealth - InsuranceHealth Maintenance OrganizationsData -see also- Census; DemographicsElectronic DocumentsEmergency Medical Services -see also- Ambul; RescSqdEvaluations and ReviewsHealth -see also- COVID19; EnvHlth; MedCon; etc.Health Care CommissionHealth Care Facilities -see also- Clinics; Hospices; etcHealth Insurance -see also- ACA; HMOs; MCOsHealth Maintenance Organizations -see also- Manage Care OrgsHealth Services Cost Review CommissionHospitals -see also- Clinics; State HospitalsInsurance AdministrationMedical Conditions -see also- AIDS; COVID-19; rabiesNonprofit OrganizationsNursing Homes -see also- AsstLiving; ContinCare; LTCarePrices -see also- Consumer Price IndexRecords -see also- Land Records; Vital RecordsRehabilitationReportsStudies -see also- Commitees & Commissions; Reports

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Bill Overview

Analyzed Economic Effects

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

Stronger ER coverage and billing protections

Beginning January 1, 2027, your Maryland health plan covers emergency care without prior authorization and whether the ER provider is in-network or not. You do not pay more cost-sharing for out-of-network ER care than in-network, and insurers must use federal rules to calculate that amount. Insurers cannot deny a covered ER service only because it did not meet the law’s emergency definition, and they cannot decide emergency status based only on diagnosis codes. Plans cannot add extra coverage hurdles beyond benefit coordination or exclusion, waiting periods, and normal cost-sharing. Insurers must treat out-of-network ER providers the same administratively and pay them using federal reimbursement standards. These rules apply to policies issued, delivered, or renewed on or after January 1, 2027.

More oversight of ER denials

Starting June 1, 2026, insurers file quarterly reports by ZIP code on members, clean claims, and grievances. Reports must show emergency cases, decision timing, length‑of‑stay denials, any use of AI tools, and how many denials get overturned. If denials jump 10% in one year or 25% over three years, carriers must explain why. The Insurance Commissioner can use these reports to examine carriers that show patterns of ER denials and can require all related records, including from review vendors. When the Commissioner orders an independent review, the insurer pays for it. The Commissioner also issues a yearly summary on post‑acute adverse decisions and grievances to the Governor and General Assembly.

State studies on hospital and post‑acute beds

Starting June 1, 2026, state health commissions study hospital and post‑acute bed capacity across Maryland. The study counts physical, staffed, and licensed beds by standard bed types. The state also studies how to speed safe moves from hospitals to post‑acute care and proposes solutions. Findings for both studies are due to the Governor and key committees by January 1, 2027.

Sponsors & Cosponsors

Sponsor

  • Harry Bhandari

    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

  • Ashanti Martinez

    House

  • Samuel I. Rosenberg

    Democratic • House

  • Kim Ross

    Democratic • House

  • Steve Johnson

    Democratic • House

  • Deni Taveras

    Democratic • House

  • Jennifer White Holland

    Democratic • House

  • Teresa Woorman

    Democratic • House

Roll Call Votes

All Roll Calls

Yes: 178 • No: 0

Senate vote • 4/13/2026

Third Reading Passed

Yes: 45 • No: 0

House vote • 3/18/2026

Third Reading Passed

Yes: 133 • No: 0 • Other: 5

Actions Timeline

  1. Approved by the Governor - Chapter 165

    4/28/2026

  2. Returned Passed

    4/13/2026House

  3. Third Reading Passed (45-0)

    4/13/2026Senate

  4. Second Reading Passed

    4/10/2026Senate

  5. Favorable Adopted

    4/10/2026Senate

  6. Favorable Report by Finance

    4/10/2026Senate

  7. Hearing 3/25 at 1:00 p.m.

    3/20/2026Senate

  8. Referred Finance

    3/19/2026Senate

  9. Third Reading Passed (133-0)

    3/18/2026House

  10. Second Reading Passed with Amendments

    3/17/2026House

  11. Favorable with Amendments {833120/1 Adopted

    3/17/2026House

  12. Favorable with Amendments Report by Health

    3/16/2026House

  13. Hearing 3/04 at 1:00 p.m.

    2/13/2026House

  14. First Reading Health

    2/13/2026House

Bill Text

  • Third Reading

    3/17/2026

    PDF

  • First Reading

    2/13/2026

    PDF

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