HGO committee approves slate of health bills; key debates on nursing licensure, school health workforce and telehealth

An array of health and government measures advanced out of the Maryland House Health and Government Operations Committee on Feb. 21, 2025, with members approving numerous bills — many with amendments — and spending the most time on changes to licensure for health professionals, a statewide school health workforce assessment and the permanence of telehealth rules.

The committee approved changes to English proficiency requirements for health occupations boards, voted to require a joint Maryland Department of Health and Maryland State Department of Education assessment of school health and wellness personnel, and made permanent several telehealth provisions including payment parity for audio-only services. Lawmakers also moved amendments on insurance referrals to nonparticipating behavioral health providers and several other departmental and administrative bills.

Why it matters: The measures touch licensing standards and workforce pipelines amid a shortage of clinicians, codify telehealth access and payment rules that affect behavioral health care delivery, and require new data collection that could inform future state workforce and funding decisions.

Licensing and English proficiency (House Bill 367) House Bill 367, sponsored by Delegate Martinez, prevents a health occupations board from requiring additional evidence of English proficiency when an applicant already holds a valid, unrestricted license, certification or registration from another state that required such evidence. A subcommittee amendment removed a requirement that boards maintain a list of other states' tests on their websites and instead requires a prominent website statement that applicants who can show prior, qualifying evidence need not repeat the process.

Delegate Martinez summarized the intent: "English is English," she said, arguing the change avoids duplicative testing and helps bring more professionals into the state amid a workforce shortage. Members pressed for data about how many other states still require standalone English-proficiency tests and for details on what those tests entail. Committee members were told an analysis would likely cost about $50,000 to produce, and members asked staff and the sponsoring delegate to obtain the requested state-by-state information before the bill reaches the full House.

The committee adopted the amendment and moved the bill out of committee. The transcript records one recorded abstention on the final vote.

School health and workforce assessment (House Bill 672) House Bill 672 requires MDH and MSDE to conduct an annual assessment of school health and wellness personnel — including school nurses, psychologists, counselors and allied specialists — and to submit a joint report to the General Assembly by Dec. 1, 2027, and annually thereafter. The bill also adds a school nurse to the Maryland Council on Advancement of School-Based Health Centers.

Proponents said the measure will produce granular, district-level data about staffing shortages and support coordinated recruitment and retention strategies. Delegate Bagnell said the bill is intended to "bring together the Department of Health and the Department of Education" to create shared data and a common language for school-based health workforce planning.

Opponents warned the measure is overly broad and could produce costly reports with unclear follow-up. Delegate Riley said she opposed the bill because it expands scope beyond school psychologists, counselors and social workers and because of concerns about cost and whether the data will lead to meaningful change. The transcript shows several members — Delegates Shaliga, Chisholm, Morgan, Riley, Hutchinson and Kipke — recorded as not wanting to be cosponsors of the bill.

Telehealth permanence and study (House Bill 869) House Bill 869 makes permanent provisions that define telehealth to include specified audio-only telephone conversations and requires reimbursement for telehealth services on the same basis and at the same rate as in-person care. The committee adopted amendments to require the Maryland Health Care Commission to conduct a study every four years on telehealth developments and to align state law with federal DEA allowances related to teleprescribing in certain circumstances.

Supporters noted the ongoing use of audio-only telehealth in behavioral health care and said the insurance market has maintained payment levels without market disruption. Committee discussion stressed existing Maryland guardrails — the prescription drug monitoring program and other oversight systems — that apply to opioid prescribing and other controlled-substance concerns raised during the telehealth debate.

Insurance referrals and nonparticipating behavioral health providers (House Bill 11) House Bill 11, sponsored by Delegate Sample Hughes, alters carrier requirements related to referral procedures for nonparticipating specialists and repeals the termination date for prior rules that required specified carriers to cover mental health and substance use disorder services from nonparticipating providers without greater cost to members. An amendment clarified when carriers must make referrals to specialists or nonphysician specialists and provided that if a carrier approves such a referral it may not impose utilization review beyond what would be required for an in-network provider. Vice Chair Collison moved the amendment and emphasized workforce shortages in behavioral health as background for the change.

Other actions and administrative bills The committee also voted in favor of a number of departmental and administrative bills that passed with limited discussion, including a departmental bill adjusting state leasing notice and advertisement requirements (House Bill 73), a bill clarifying delegation authority for the Public Access Ombudsman (House Bill 331), amendments to the Maryland Cybersecurity Council membership (House Bill 376), changes to the 9-1-1 Trust Fund purpose to allow shared costs with the 988 suicide prevention hotline (House Bill 421), authorization for MDEM and the Maryland 9-1-1 Board to adopt implementing regulations (House Bill 423), a prohibition on residential property liens for medical debt (House Bill 428), designation of locations for an American Braille tactile flag in veterans' cemeteries (House Bill 455), changes to emergency evaluation petition durations (House Bill 468), Medicaid coverage for validated home blood pressure monitors beginning Jan. 1, 2026 for specified populations (House Bill 553), expedited licensure timelines for behavior analysts (House Bill 745) and a work group to study the rise in adverse coverage decisions (House Bill 995). Where the record shows subcommittee amendments were adopted, those amendments were reported to the full committee and carried in the committee votes.

Votes at a glance - HB 11 (Sample Hughes) — Health insurance access to nonparticipating providers: passed as amended (amendment clarifies referral circumstances and limits additional utilization review). (Amendment moved by Vice Chair Collison.) - HB 73 (State leasing, DGS) — departmental bill changing size thresholds and advertising requirements: passed as amended (subcommittee amendment retained newspaper advertisement requirement). - HB 331 (Public Information Act, Public Access Ombudsman) — delegation of powers to staff with training/ expertise limitation: passed as amended. - HB 367 (Martinez) — English proficiency requirements for licensure by endorsement: passed as amended (amendment removed requirement to list other states on boards' websites; one abstention recorded). - HB 376 (Maryland Cybersecurity Council) — appointment and chair selection changes: passed as amended. - HB 421 (9-1-1 trust fund / 988 hotline costs) — passed unanimously. - HB 423 (MDEM and Maryland 9-1-1 Board regulatory authority) — passed. - HB 428 (Medical debt; liens on owner-occupied property prohibited) — passed as amended (definitions refined; prospective application only). - HB 455 (Braille Flag Memorial Act) — passed as amended. - HB 468 (Petitions for emergency evaluation) — passed as amended (clarifies duration, extensions and naming amendment adopted). - HB 553 (Medicaid coverage for self-measured blood pressure monitoring) — passed as amended (coverage begins 01/01/2026; validated monitors to be covered for specified recipients). - HB 672 (School health and wellness personnel assessment) — passed as amended (annual assessment; MDH/MSDE reporting by 12/01/2027; addition of school nurse to council). Several members recorded as not wanting to be cosponsors. - HB 722 (MDH report on oversight of SUD treatment programs and recovery residences) — passed. - HB 745 (Behavior analyst licensure timelines and notice requirements) — passed as amended (timelines set to 30/50 days). - HB 869 (Preserve Telehealth Access Act) — passed as amended (audio-only telehealth defined permanently; payment parity; periodic study; teleprescribing alignment with DEA). - HB 995 (Work group on adverse decisions in the state health care system) — passed as amended (membership/staffing adjustments).

What’s next The bills that passed the committee will proceed to the House floor for further consideration. Several sponsors committed to providing additional information requested by committee members — notably a state-by-state breakdown on English-proficiency testing and other clarifications — before floor debate.

Sources: Health and Government Operations Committee, Feb. 21, 2025 transcript of voting list #5; committee comments and recorded roll-call remarks.