Bill > HB848

This bill aims to improve transparency and communication in health insurance adverse decisions and grievance processes in Maryland. It requires health insurance carriers to provide more detailed and clear written notices when denying health care services, including specific requirements for the content and format of these notices. Carriers must now include a prominent bold header explaining the notice is a service denial, provide unique identifiers for the decision-makers, explain the specific reasons for denial using clear language, and avoid generalized terms like "not medically necessary". The bill also mandates that carriers include contact information for the Health Advocacy Unit and the Insurance Commissioner, and provide details about filing complaints or appeals. Additionally, private review agents must now post utilization review criteria on member and provider website pages, maintain dedicated contact methods for utilization review, and respond to communications within two business days. Insurance carriers will be required to submit quarterly reports with information aggregated by zip code, including details about adverse decisions, and must explain significant increases in adverse decisions for specific types of services. The bill is designed to make the health insurance decision-making process more transparent and accessible to patients and healthcare providers.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0848?ys=2025RS