Bill > SB776

This bill establishes a Workgroup to Study the Rise in Adverse Decisions in the State Health Care System, which will be composed of 18 members representing various stakeholders including legislators, state agencies, healthcare providers, insurers, and patient advocacy groups. The Workgroup's primary responsibilities include reviewing existing adverse decision reporting requirements across all health payers in the state, with a mandate to analyze data such as the number of adverse decisions compared to total claims processed, health plan enrollment, diagnostic information, and network accessibility. Members will develop recommendations to improve state reporting on adverse decisions, including creating standardized definitions for medical service categories, health settings, adverse decisions, and medical necessity. The Workgroup will also develop strategies to reduce the number of adverse decisions and propose legislative recommendations to standardize reporting requirements. The members will not receive compensation but can be reimbursed for expenses, and they will elect their own chair. The Health Services Cost Review Commission and Maryland Insurance Administration will provide staff support. The Workgroup is required to submit its findings and recommendations to the Senate Finance Committee and House Health and Government Operations Committee by December 1, 2025, and the bill will remain in effect until June 30, 2026.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0776?ys=2025RS