Bill > HB1341

This bill requires health insurance carriers in Maryland to enhance their customer support and transparency in handling insurance claim denials. Specifically, carriers must establish a 24-hour call center staffed by employees trained annually in state insurance laws, where members can appeal adverse decisions. When a carrier issues an adverse decision (a denial of a health care service), they must provide a detailed written notice within 5 working days that clearly explains the specific reasons for the denial, avoiding generalized language. The notice must include contact information for the carrier's decision-makers, details about the internal grievance process, and important consumer protection information such as the right to file a complaint with the Insurance Commissioner. The bill also mandates that carriers include a prominent statement in 14-point bold font explaining how to get free help understanding the denial, a QR code linking to a guidance video, and the call center's telephone number. Additionally, carriers must conduct an annual survey of members' experiences with their internal grievance process and submit the survey results to the Insurance Commissioner. The Commissioner will develop a instructional video to help members navigate the appeals process. These requirements aim to make the insurance appeals process more transparent, accessible, and user-friendly for consumers. The bill will take effect on October 1, 2025.

Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB1341?ys=2025RS