Natural Resources - Chesapeake Bay Trust - Urban Trees Program
Summary
HB1314 would regulate how prior authorization is handled in Maryland health coverage. It prohibits insurers, nonprofit health service plans, and health maintenance organizations from using artificial intelligence to automatically deny prior authorization requests. The bill also bars in-network health care providers from charging a fee to obtain a prior authorization from a carrier or managed care organization.
The bill defines key terms such as “carrier,” “health care provider,” “prior authorization,” and “artificial intelligence,” and applies to health insurance policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2026. In practical terms, it adds a consumer- and provider-protection rule to Maryland insurance and health care law by limiting automated denial practices and eliminating a billing practice tied to the prior authorization process.
Impact
The bill amends both the Health-General Article and the Insurance Article of the Maryland Code by creating a new subtitle on fees for prior authorizations and adding a new insurance provision governing artificial intelligence use. It affects insurers, nonprofit health service plans, HMOs, managed care organizations, and in-network health care providers by restricting denial automation and prohibiting provider fees for obtaining prior authorization. The law would apply prospectively to covered policies and contracts beginning January 1, 2026.
Sentiment
The available voting history suggests strong support for the bill, with third reading passage by a wide margin of 136 yeas to 3 nays. The committee report was favorable with amendments, indicating the bill advanced with broad legislative approval while still being refined during the process. No committee transcript excerpts were provided, so the record reflects overall support rather than detailed debate.
Contention
The main policy concerns appear to center on the use of artificial intelligence in utilization management and whether automated systems should be allowed to make or trigger prior authorization denials. Another point of potential contention is the prohibition on fees charged by in-network providers for obtaining prior authorization, which could affect administrative practices and reimbursement arrangements between providers and carriers. The narrow number of negative votes suggests some disagreement remained, likely over regulatory burden, insurer discretion, or the operational impact on health plans and providers.