This report is based, in part, on the multi-page summary of this year’s legislative session from our lobbyists, Christine Krone and Pam Metz Kasemeyer, JD; Schwartz, Metz and Wise, PA.

Interstate Social Work Licensure Compact

It is likely not news to most of you that the Social Work Licensure Compact (House Bill 34) was not passed this year by the MD Legislature. Unfortunately, although it passed through the House, the bill was never brought to a vote in the Senate Finance Committee and Senate Bill 204 faced the same fate. Despite our members strong advocacy, which included grassroots efforts, letter writing campaigns, and legislator meetings, the Chair of the Senate Finance Committee strongly felt that the Workgroup on Social Worker Requirements for Licensure (appointed through legislation passed in the 2023 session) should conclude its work and that by passing the Compact, it would be an endorsement of the unequitable ASWB exam. We will work hard during this summer and fall to figure out the best focus for additional information and contacts that may help to get the Compact passed in Maryland in 2025.

*Changes in Record-Keeping Requirements*

House Bill 149: Medical Records-Destruction-Notice and Retrieval (passed) extends the period that a provider must keep medical records. Currently in Maryland, we are required to keep records for 5 years after the last patient contact; this will increase to 7 years which is consistent with current Medicare requirements. We are currently required to keep minors’ records for 3 years after the patient turns 18; the time will be extended to keeping minors’ records for 7 years after the patient turns 18. Providers may destroy records in less time than this if proper notice is provided. Currently, “proper notice” requires public notice in a newspaper of general circulation; new provisions will allow notice to be given by email and letter. This bill goes into effect on October 1, 2024.

Revisions to Utilization Review passed

After almost two years of advocacy and negotiations, Senate Bill 791/House Bill 932: Health Insurance-Utilization Review-Revisions passed the General Assembly. After a successful interim workgroup, Vice Chair of the Senate Finance Committee Kathy Klausmeier and Vice Chair of the House Health and Government Operations Committee Bonnie Cullison introduced the bill as “consensus legislation,” with all parties agreeing to support. However, a few weeks into session, CareFirst reneged on its support and raised an issue with the reauthorization provision of the legislation. That provision would prohibit an insurer from issuing a denial upon a request for renewal of a prior authorization when the insurer previously approved the prescription drug that the patient had been treated with without interruption. The prescriber would have also attested that the drug continued to be necessary to effectively treat the patient’s condition. Equally frustrating and more importantly, the MD Dept of Budget and Management sent a letter to the committees stating the legislation would cost the State Employee Health Benefit Plan approximately $91 million. The General Assembly could not ignore this cost given the difficulty the house and senate had agreeing on a budget. The committees wound up dealing with the fiscal note by limiting the reauthorization clause to a prescription drug to treat a patient’s mental health disorder or a prescription drug that is an immune globulin. All other protections remain fully in the bill. See informative memo from our lobbyists elsewhere in this newsletter.

Board of Social Work Examiners

House Bill 755/Senate Bill 106: State Board of Social Work Examiners - Board Membership and Certified Social Worker Licenses (passed) alters the membership of the State Board of Social Work Examiners (BSWE) by authorizing the board to include at least one member who is either a licensed certified social worker or a licensed master social worker who is approved for independent practice. The bill also makes clarifying changes and removes obsolete references to certified social worker licenses. The bill took effect June 1, 2024.

Required by the Maryland Program Evaluation Act, Senate Bill 242: State Board of Social Work Examiners - Sunset Extension (passed) extends the authority of the BSWE to July 1, 2030. The BSWE is also now required to report to the Senate Finance Committee and the House Health and Government Operations (HGO) Committee the average processing time for issuing initial licenses and renewal licenses; the average length of time required to resolve a complaint; and the rate of compliance for reviewing completed applications for a license and notifying the applicant they were approved to take the appropriate exam within the required amount of time (a total of 75 days).

Enhancing the MD Insurance Administration’s Parity Enforcement Authority

Senate Bill 684/house bill 1074: Health Insurance – Mental Health and Substance Use Disorder Benefits – Sunset Repeal and Modification of Reporting Requirements (passed) enacts many of the recommendations from the MD Insurance Administration’s (MIA) report, strengthening parity compliance reporting requirements for carriers and enhancing the MIA’s parity enforcement authority. Specifically, the bill:

• Removes the sunset on carrier reporting requirements, requiring carriers to continue submitting compliance reports every other year.
• Reduces the scope of carrier compliance reports to just those nonquantitative treatment limitations (NQTL) identified by MIA as having the biggest impact on access to care, improving the efficiency and effectiveness of the agency’s parity analyses.
• NQTLs are processes, strategies, evidentiary standards, or other criteria that limit the scope or duration of benefits for services provided in a health insurance plan, including things like prior authorization, concurrent review, network adequacy, and provider reimbursement.
• Requires carriers to document compliance for all NQTLs annually and submit their reports to the MIA upon request within 15 days. Plan members are also authorized to request NQTL reports from their insurance carrier and receive those reports within 30 days, regardless of whether the member has filed a grievance, appeal, or complaint.
• Places the burden of persuasion on the carriers to demonstrate parity compliance and provides that a failure to submit a complete report shall be considered a parity violation.
• Authorizes MIA to penalize carriers financially for each day a carrier does not submit requested information, charge carriers for expenses incurred by the MIA for additional reviews required beyond the initial review, and should the agency be unable to determine compliance due to an incomplete carrier report, order the carrier to modify or cease the conduct or practice.

There were many bills that impact us, our profession, and our clients lives that we assessed what position to take during this legislative session and wrote testimony for or against. I will continue to report on these bills in subsequent newsletters.