Bill > HB1376

This bill requires the Maryland Medical Assistance Program and the Maryland Children's Health Program, which provide health coverage to eligible low-income residents and children, to make a decision on whether a transfer to a special pediatric hospital is approved within three business days of receiving a request from the hospital. A "special pediatric hospital" is defined as a facility providing specialized medical, rehabilitation, therapy, and palliative services to individuals under 22 years old, or those aged 2-23 with co-occurring physical and behavioral health conditions. Additionally, the Maryland Department of Health must create regulations by December 31, 2026, to establish a process for reviewing past medical necessity decisions for these special pediatric hospitals, including provisions for peer-to-peer reconsideration and reviews conducted by licensed physicians.