MarylandMaryland limits cost sharing for coordinated primary care services
Maryland Medical Assistance recipients and many health plan members can get Collaborative Care Model services without most cost sharing, with private plan rules applying to qualifying coverage starting January 1, 2027.
What it does
Maryland Medical Assistance recipients pay no copay, coinsurance, or deductible for Collaborative Care Model services in primary care settings statewide.
For policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2027, covered plans must cover these services and generally may not charge copays, coinsurance, or deductibles. High-deductible plan deductibles may still apply.
The Maryland Health Care Commission must study how eliminating cost sharing for Collaborative Care Model services affects coverage, then report its findings and recommendations to two legislative committees.
Argument forPeople using coordinated primary care may pay less out of pocket for these services, which could make it easier to receive ongoing behavioral health support.
Argument againstPeople in high-deductible plans may still owe their deductible for these services, so the rule may leave them with some costs.
More detail
The Maryland Department of Health may not require copays, coinsurance, or deductibles for these services. This applies statewide in primary care settings that serve Maryland Medical Assistance recipients. The care model coordinates physical and behavioral health care, tracks outcomes, and includes specialist reviews. This rule takes effect July 1, 2026.
Covered insurers, nonprofit health plans, and health maintenance organizations must cover these services and generally may not charge cost sharing. The rule covers qualifying individual, group, or blanket hospital, medical, or surgical benefits. The rule applies to specified health benefits under policies or contracts issued or delivered in Maryland. A high-deductible health plan may still apply its deductible. These rules apply to policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2027.
The Maryland Health Care Commission must study the impact of eliminating cost sharing and report its findings and recommendations. The Commission must report to the Senate Finance Committee and the House Health Committee. The study concerns specified insurers, nonprofit health service plans, and health maintenance organizations that cover Collaborative Care Model services. The Commission must complete the study and report by December 1, 2026.
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Where it stands
- Introduced
- Passed House
- Passed Senate
- To Governor
- Became Law
Looking ahead
No hearings or votes scheduled.
History
- 2026
- May 26Approved by the Governor Wes Moore - Chapter 615Became Law
- Apr 9Returned Passed
- Apr 8Third Reading PassedPassed Senate
- Apr 7Second Reading Passed
- Apr 7Favorable AdoptedMinor
- Apr 6Favorable Report by FinanceMinor
- Mar 20
- Vote recorded On Third Reading. Result: pass.Upper
- Mar 19Referred FinanceMinor
- Mar 18Third Reading PassedPassed House
- Mar 17Second Reading Passed with Amendments
- Mar 17Favorable with Amendments {Minor
- Mar 16Favorable with Amendments Report by HealthMinor
- Mar 5
- Vote recorded On Third Reading. Result: pass.Lower
- Feb 19Hearing 2/19 at 1:30 p.m.
- Feb 19Hearing canceled
- Feb 4Hearing 2/19 at 1:00 p.m.
- Feb 4First Reading HealthIntroduced
HealthcareMental Health