Maryland Medical Assistance Program and Health Insurance - Collaborative Care Model - Cost Sharing Prohibition and Coverage Requirements
Summary
HB746 requires the Maryland Department of Health and certain private health coverage entities to cover services delivered under the Collaborative Care Model and bars most cost-sharing for those services. The Collaborative Care Model is defined as an evidence-based approach that integrates behavioral health and somatic care in primary care settings through care coordination, outcome monitoring, and psychiatric or substance use disorder consultation. For Medicaid/Medical Assistance recipients, the bill directs the Department to reimburse these services statewide in primary care settings and prohibits copays, coinsurance, and deductibles for those services.
For private insurance, the bill adds a new Insurance Article section applying to insurers, nonprofit health service plans, and health maintenance organizations that offer hospital, medical, or surgical coverage in Maryland. Those entities must provide coverage for Collaborative Care Model services and generally may not impose copayments, coinsurance, or deductibles, although high-deductible health plans may still apply their deductible requirements. The bill also requires the Maryland Health Care Commission to study the impact of eliminating health insurance cost-sharing for these services and report findings and recommendations to the General Assembly by December 1, 2026. The insurance provisions apply to policies and plans issued, delivered, or renewed on or after January 1, 2027.
Impact
The bill amends the Health - General Article and adds a new Insurance Article mandate, expanding coverage obligations for both the Maryland Medical Assistance Program and regulated private health plans. It would require statewide reimbursement for Collaborative Care Model services in primary care settings serving Medicaid recipients and would prohibit most patient cost-sharing for those services. It also creates a new coverage requirement for private insurers, nonprofit health service plans, and HMOs, with a limited exception for high-deductible health plans, and directs a state study that could inform future policy changes.
Sentiment
The voting history suggests strong bipartisan support for the bill, with overwhelming passage in both chambers and only minimal opposition in the House. The lack of recorded committee transcript discussion limits insight into detailed debate, but the broad margins indicate the bill was generally viewed favorably. The measure appears to have been treated as a health access and behavioral health integration bill rather than a controversial insurance mandate.
Contention
The main policy tension in HB746 is between expanding access to integrated behavioral health care and limiting cost-sharing, versus concerns about added insurance mandates and potential premium or utilization effects. The bill’s exception for high-deductible health plans suggests lawmakers were attentive to federal tax-qualified plan rules and the practical limits of a full cost-sharing ban. The required Maryland Health Care Commission study also indicates that the fiscal and market impact of eliminating cost-sharing was an open question, even though the bill itself moved forward with strong support.