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Rosen & Kessler: New health care laws in Maryland

The Maryland General Assembly’s 2022 legislative session resulted in the enactment of many new health care laws that will impact health care facilities, providers and insurers in the State. Here are some of the highlights from the 2022 session.

Value-based care: New value-based care legislation:  (1) amends the Maryland Self-Referral Law to align with federal law permitting health care providers to be paid under certain value-based arrangements; (2)  amends the law governing health care practitioner compensation arrangements with insurers and health maintenance organizations to permit voluntary two-sided incentive arrangements with certain health care practitioners in which the practitioner can assume risk; and (3) clarifies that health care practitioners accepting capitated payments from insurers, health maintenance organization and certain self-funded employer health plans are not themselves required to be licensed as insurers.

There are a number of changes that involve accessibility to prescription medications and medical devices.

New authorizations. A nurse anesthetist will be authorized to prescribe, order and administer drugs, including controlled dangerous substances, limited to a 10-day supply, to patients in connection with anesthesia service.

Registered nurse practitioners will be authorized to prescribe and dispense auto-injectable epinephrine to certain certificate holders at youth camps. Pharmacists meeting certain requirements will be authorized to prescribe and to dispense nicotine replacement therapy medications. Pharmacists will also be authorized to administer injectable medications for treatment of sexually transmitted infections.

A paramedic’s authority to administer influenza and 2019CoV immunizations under certain circumstances will not be repealed until January 1, 2025.

Expanded access. Managed care organizations (MCOs) and certain insurers, nonprofit health service plans, and health maintenance organizations will be prohibited from applying a prior authorization requirement for prescription drugs used as post-exposure prophylaxis for the prevention of HIV.

Insurers, nonprofit health service plans, and health maintenance organizations will be prohibited from charging more than $30 for a 30-day supply of a covered prescription insulin drug, and they must remove the requirement that rituximab be approved by the federal Food and Drug Administration to provide coverage for the treatment of certain pediatric autoimmune neuropsychiatric disorders.

In regards to facilities:

Assisted living.  The Maryland Health Care Commission must conduct a study regarding the quality of care provided by assisted living programs with nine or fewer beds, and report its recommendations, including any draft legislation, to the governor, the Department of Health and certain committees of the General Assembly.

Hospitals.  The Health Services Cost Review Commission must develop a process for identifying patients who paid for hospital services but may have been qualified for free care during calendar years 2017 through 2021, and a process that causes the applicable hospital to reimburse the identified patients. The bill also requires hospitals to implement the recommended processes by January 1, 2023.

Residential service agencies. Residential service agencies billing Medicaid will now have new obligations to file annual reports with the Maryland Department of Health.

HIEs.  The definition of a Health Information Exchange has been redefined, subjecting additional entities to regulation by the Maryland Health Care Commission.

Barry F. Rosen is the chairman & CEO of the law firm of Gordon Feinblatt LLC, heads the firm’s health care practice group, and can be reached at 410-576-4224 or K. Eva Kessler is the research services administrator of Gordon Feinblatt LLC, and can be reached at 410-576-4251 or