Judy Gallant, MD Legislation and Advocacy Chair

This report is based, in part, on the multi-page summary of this year’s legislative session from our lobbyist, Pam Metz Kasemeyer, JD.

The Maryland General Assembly completed its 2022 legislative session on Monday, April 11.

Budget Issues

The only legislation required to pass each year is a budget, and that job was made easier this year with a surplus larger than the State has seen in its history, thanks to federal funds sent down through COVID-19 relief legislation and the Build Back Better infrastructure monies.

The budget committees have instructed State agencies to submit reports on various issues. One of specific interest to the practice of social work is the report on Optum.

Optum-Medicaid Specialty Mental Health System: Budget language was adopted which withholds $1 million from the Maryland Department of Health (MDH) pending a report on the actual amount of overpayments outstanding, recoupment and forgiveness of overpayments, the total number and total amount of claims still in dispute, and more. Since Optum assumed the ASO contract, its implementation has been catastrophic, and the provider community continues to look for avenues to address the total chaos regarding claims management. (The ASO is the Administrative Service Organization for the specialty mental health contract carved out under Medicaid’s HealthChoice program.) The report on the Optum issue is due from the MDH on August 1, 2022.

The relevant Committees in the House and Senate have been very engaged in gathering information on the Optum controversy and have expressed an interest in making MDH accountable for resolving the problems. A bill failed that was introduced to address the challenges providers have faced in resolving claims with Optum, in part due to strong pushback by Optum and MDH and the inability to determine the actual fiscal impact of the bill. The legislation’s failure was especially disheartening to the behavioral health community, given the continued challenges we face. Perhaps the directives by  the budget committees will provide a pathway to resolution of these issues, although they will not provide the immediate relief necessary. These recoupment plans are moving forward despite the lack of reliable data to reconcile historical payments and services.

Health Insurance Coverage

House Bill 912/Senate Bill 707: Health Insurance-Provider Panels-Coverage for Nonparticipation: This bill passed and will require a carrier to ensure that service provided by a nonparticipating specialist (including those licensed for treatment of mental health or substance use disorders) are provided at no greater cost than if the covered benefit were provided by a practitioner on the carrier’s provider panel. (Managed Care Organizations [MCOs] are exempt from this requirement.) Each carrier must inform members of the procedure to request a referral to a specialist or non-physician specialist, and the Consumer Education and Advocacy Program must provide public education to inform consumers of these procedures. By December 31, 2022, each health occupations board that regulates mental health or substance use disorder providers must report to the General Assembly on their progress in developing a process for providing information to carriers for the purpose of carriers reaching out to providers regarding participation in provider panels.

Early Intervention for Children

House Bill 725/Senate Bill 506: Therapeutic Child Care Grant Program-Establishment: This bill creates a Therapeutic Child Care Program and mandates an appropriation in the Governor’s annual budget to fund the Program. Therapeutic Child Care Programs provide specialized childcare and early childhood education to children under the age of 6 who have developmental delays, including physical disabilities or delays in social, emotional or behavioral functioning. This bill takes effect July 1, 2022.

Health Crisis Response Services

House Bill 293/Senate Bill 241: 9-8-8 Trust Fund: This bill establishes the 9-8-8 Trust Fund in order to provide reimbursement for costs associated with designating and maintaining 9-8-8 as the universal telephone number for a national suicide prevention and mental health crisis hotline and developing and implementing a Statewide initiative for the coordination and delivery of the continuum of behavioral health crisis response services in the State. In 2020, Congress passed the National Suicide Designation Act of 2020, which establishes 9-8-8 as a universal number for mental health crises and suicide prevention. In July 2022, 9-8-8 will go live. All phone companies will then route 9-8-8 calls to local crisis call centers that are part of the Lifeline network. Local crisis call centers provide 24/7 free, confidential emotional support to individuals calling for help. Our State bill included $5 million for FY 2023 and $5.5 million in funding for the FY 2024 budget.

Unfortunate failed advocacy efforts

Many of the bills we advocated for this year, including the Behavioral Health System Modernization Act, and a number of bills related to the practice of social work, did  not pass to become law during this legislative session. We will report further on those in our next newsletter report.