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Bill to make out‑of‑network protections permanent draws broad support from advocates, insurers and providers
Summary
House Bill 11 would make permanent and refine a statute allowing insured Marylanders to obtain behavioral‑health services from out‑of‑network providers without additional financial penalty when in‑network access is unreasonable.
Delegate Sample‑Hughes presented House Bill 11, which would make permanent and refine protections that allow insured Marylanders to obtain behavioral‑health care from out‑of‑network providers without additional financial penalty when in‑network access is unreasonably delayed or requires unreasonable travel.
Advocates, patient groups, legal services and provider organizations testified in support. Legal Action Center and the Maryland Parity Coalition said the protections are modeled on NAIC guidance and adopted in many states; they told the committee that Marylanders go out of network far more often for behavioral health care than for medical care and that the protections are an essential consumer backstop while the state addresses longer‑term network adequacy and workforce problems.
CareFirst and other carriers testified that they had worked with the sponsor and supported the bill “with amendments,” noting a few drafting clarifications and asking for definitions (for example, for “treatment plan”) and for consistent procedures for carriers to provide assistance. Carriers also reiterated their concern about low behavioral‑health reimbursement and urged the legislature to study rates for broader workforce retention.
Children’s National and clinicians testified about families who waited months for in‑network appointments and said the protections reduced unnecessary emergency department use and prevented longer hospital stays. Disability Rights Maryland and parent advocates told the committee that families often need rapid access to out‑of‑network specialists and that balance‑billing protections and streamlined referrals prevent long, costly delays.
Ending: Lawmakers and stakeholders reported progress from negotiations and technical drafting. The sponsor said she would continue to work with the Maryland Insurance Administration and carriers to refine definitions and procedural guidance; the transcript shows support for making the protections permanent with technical amendments but no recorded committee vote.
