Committee hears bill to eliminate co‑pays for collaborative behavioral health in primary care

Senate Bill 428 would prohibit Maryland Medicaid and certain state‑sponsored commercial plans from imposing patient cost sharing—co‑pays, coinsurance or deductibles—for behavioral health services provided through the collaborative care model in primary care settings.

Sponsor Senator Malcolm Augustine described the model as evidence‑based and patient‑centered, saying it has been validated in more than 90 randomized trials and can meaningfully expand access, particularly in rural areas. "Removing that cost share barrier" was presented as key to preventing drop‑off after initial visits and improving uptake of follow‑up care.

Supporters included the Mental Health Association of Maryland, the Maryland Health Care Commission (represented by David Sharp), children's psychiatry leaders, addiction advocates and providers. MHCC's director testified the bill "strengthens Maryland's ability to access integrated behavioral health services by removing a key barrier to participation" and linked the proposal to federal trends toward integration and value‑based care.

Committee members asked for fiscal specifics, including per‑member per‑month cost estimates of eliminating co‑pays; MHCC said it did not have that figure on hand and offered to follow up. Witnesses noted prior Medicaid pilot programs and adoption by other payers, and proponents argued the model reduces total system costs through better chronic disease management and fewer high‑cost downstream events.

The chair clarified the bill's scope: it applies to state‑originated plans including state employees (about 28% of insureds) and to Medicaid but not to plans purchased out‑of‑state or federal plans. The panel concluded after the committee had no further questions.