Maryland bill would require insurers, Medicaid to cover reconstructive care for domestic violence survivors

Delegate Ashanti Martinez, sponsor of House Bill 381, told the House Health and Government Operations Committee the bill would require the Maryland Medical Assistance Program and private insurers to cover aesthetic services and restorative care for victims of domestic violence.

The measure, called the Healing Our Scars Act, aims to ensure survivors who present with scars, dental injuries or other trauma-related injuries can receive “medically necessary” reconstructive treatment without bearing the full cost out of pocket.

Supporters said the coverage change would bring Maryland in line with other states and existing philanthropic programs. Councilmember Crystal Oriana of Prince George’s County testified as a survivor and described a decade-long delay before she could access repair for an injury caused by domestic violence; she told the committee that reconstructive care helped restore quality of life and the ability to move forward.

Delegate Martinez said the bill would follow the example of other states and existing charitable programs and that she was working with the Maryland Department of Health on amendments to limit budgetary impact. Department materials were included in the sponsor packet, and Martinez told members she was seeking cost‑neutral approaches where possible.

Committee members pressed for details about how eligibility would be documented, with questions about whether police reports or other records would be required and how clinicians would certify that a procedure was medically necessary. Martinez said physicians would determine medical necessity and that the bill’s language contemplates use of clinical coding (for example, sequela codes for late effects of injury) to bill for scars that were not treated immediately after an assault.

Several clinicians on the panel—including a plastic surgeon in the room—asked how claims are currently coded and what gaps the bill would fill. Martinez and advocates said their aim was to make coverage available for survivors who never reported assaults or who were unable to pursue court remedies, not to supplant criminal accountability.

Opposition testimony from the insurance trade (the League of Life & Health Insurers) raised questions about identification of victims, whether perpetrators should be responsible for costs, and the potential fiscal impact; Martinez said she had shared the bill with insurer representatives and invited continued discussion to narrow language and resolve fiscal concerns.

The bill proceeded as a hearing item; no committee vote or final action was recorded in the transcript. Supporters asked members for a favorable report and said they would continue working with the department and insurers on clarifying amendments.

Ending: The committee heard substantive policy and implementation questions about provider certification, documentation of domestic violence, and cost‑neutral mechanisms for funding coverage. Sponsors and advocates said they will continue to negotiate language with the department and insurers before the measure advances.