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*hb0442*
HOUSE BILL 442
J3, J2 6lr1742
CF SB 293
By: Delegates Kaufman, Embry, Patterson, Ruff, Wims, and Woorman Woorman,
Alston, Bagnall, Cullison, Guzzone, Hill, Hutchinson, S. Johnson, Kipke,
Lopez, Martinez, M. Morgan, Reilly, Rosenberg, Ross, Taveras, and
White Holland
Introduced and read first time: January 22, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: February 18, 2026
CHAPTER ______
AN ACT concerning 1
Professional Liability Insurance Coverage – Nursing Homes, Assisted Living 2
Facilities, and Nurse Midwives, and Licensed Certified Midwives – Disclosure 3
(Nyeli Rose Lewis Act of 2026) 4
FOR the purpose of requiring nursing homes, assisted living programs, and nurse 5
midwives, and licensed certified midwives to notify certain individuals at certain 6
times if the nursing home, assisted living program, or nurse midwife , or licensed 7
certified m idwife either does not maintain professional liability insurance or 8
professional liability insurance coverage has lapsed and has not been renewed; and 9
generally relating to professional liability insurance disclosures. 10
BY repealing and reenacting, without amendments, 11
Article – Health – General 12
Section 19–1401(a) and (e) and 19–1801 13
Annotated Code of Maryland 14
(2023 Replacement Volume and 2025 Supplement) 15
BY adding to 16
Article – Health – General 17
Section 19–1417 and 19–1808.1 18
Annotated Code of Maryland 19
(2023 Replacement Volume and 2025 Supplement) 20
2 HOUSE BILL 442
BY repealing and reenacting, with amendments, 1
Article – Health – General 2
Section 19–1417 3
Annotated Code of Maryland 4
(2023 Replacement Volume and 2025 Supplement) 5
BY adding to 6
Article – Health Occupations 7
Section 8–604 and 8–6D–15 8
Annotated Code of Maryland 9
(2021 Replacement Volume and 2025 Supplement) 10
BY repealing and reenacting, with amendments, 11
Article – Health Occupations 12
Section 8–6D–15 13
Annotated Code of Maryland 14
(2021 Replacement Volume and 2025 Supplement) 15
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 16
That the Laws of Maryland read as follows: 17
Article – Health – General 18
19–1401. 19
(a) In this subtitle the following words have the meanings indicated. 20
(e) (1) “Nursing home” means a facility that offers nonacute inpatient care to 21
patients suffering from a disease, chronic illness, condition, disability of advanced age, or 22
terminal disease requiring maximal nursing care without continuous hospital services and 23
who require medical services and nursing services rendered by or under the supervision of 24
a licensed nurse together with convalescent, restorative, or rehabilitative services. 25
(2) “Nursing home” does not mean a facility offering domiciliary care or 26
personal care as those terms are defined in § 19–301 of this title. 27
19–1417. 28
(A) EACH NURSING HOME IN THE STATE SHALL NOTIFY EA CH RESIDENT 29
AND PROSPECTIVE RESI DENT IN WRITING OR B Y WRITTEN ELECTRONIC 30
COMMUNICATION IF: 31
(1) THE NURSING HOME DOES NOT MAINTAIN PROFESSIONAL 32
LIABILITY INSURANCE COVERAGE; OR 33
HOUSE BILL 442 3
(2) THE NURSING HOME ’S PROFESSIONAL LIABI LITY INSURANCE 1
COVERAGE HAS LAPSED FOR ANY PERIOD OF TIME AND HAS NOT BEEN RENEWED. 2
(B) THE NOTIFICATION UNDE R SUBSECTION (A) OF THIS SECTION SHAL L 3
BE: 4
(1) (I) PROVIDED TO A PROSPECTIVE RESIDENT: 5
1. AT THE FIRST VISIT BY THE PROSPECTIVE RESIDENT 6
DURING ANY PERIOD DU RING WHICH THE NURSI NG HOME DOES NOT MAI NTAIN 7
PROFESSIONAL LIABILITY COVERAGE; AND 8
2. IF THE NURSING HOME D OES NOT MAINTAIN 9
PROFESSIONAL LIABILITY INSURANCE AT THE TIME THE PROSPEC TIVE RESIDENT 10
APPLIES FOR ADMISSION, AT THE TIME OF APPLICATION; AND 11
(II) IF THE PROFESSIONAL L IABILITY INSURANCE L APSES, 12
PROVIDED TO EACH RES IDENT WITHIN 30 DAYS AFTER THE DATE THE COVERAGE 13
LAPSED; 14
(2) SIGNED BY: 15
(I) THE PROSPECTIVE RESID ENT AT THE TIME OF 16
APPLICATION FOR ADMISSION; OR 17
(II) THE RESIDENT AT THE T IME THE NOTIFICATION OF THE 18
LAPSE IN COVERAGE IS PROVIDED UNDER ITEM (1)(II) OF THIS SUBSECTION; AND 19
(3) RETAINED BY THE NURSI NG HOME AS PART OF THE NURSING 20
HOME’S RECORDS. 21
(C) EACH NURSING HOME OPE RATING IN THE STATE THAT DOES NOT 22
MAINTAIN PROFESSIONA L LIABILITY INSURANC E COVERAGE SHALL POS T IN A 23
CONSPICUOUS PLACE VI SIBLE TO RESIDENTS A ND GUESTS THAT THE N URSING 24
HOME DOES NOT MAINTAIN PROFESSIONAL LIABILITY COVERAGE. 25
[19–1417.] 19–1418. 26
This subtitle may be cited as the “Maryland Nursing Home Quality Assurance Act”. 27
19–1801. 28
In this subtitle: 29
4 HOUSE BILL 442
(1) “Assisted living program” means a residential or facility –based 1
program that provid es housing and supportive services, supervision, personalized 2
assistance, health –related services, or a combination thereof that meets the needs of 3
individuals who are unable to perform or who need assistance in performing the activities 4
of daily living or instrumental activities of daily living in a way that promotes optimum 5
dignity and independence for the individuals. 6
(2) “Assisted living program” does not include: 7
(i) A nursing home, as defined under § 19–1401 of this title; 8
(ii) A State facility, as defined under § 10–101 of this article; 9
(iii) A program licensed by the Department under Title 7 or Title 10 10
of this article; 11
(iv) A hospice care program regulated by the Department under 12
Subtitle 9 of this title; 13
(v) Services provided by family members; 14
(vi) Services provided in an individual’s own home; or 15
(vii) A program certified by the Department of Human Services under 16
Title 6, Subtitle 5, Part II of the Human Services Article as a certified Adult Residential 17
Environment Program. 18
19–1808.1. 19
(A) EACH ASSISTED LIVING PROGRAM IN THE STATE SHALL NOTIFY A 20
RESIDENT OR PROSPECT IVE RESIDENT IN WRIT ING OR BY WRITTEN EL ECTRONIC 21
COMMUNICATION IF: 22
(1) THE ASSISTED LIVING P ROGRAM DOES NOT MAIN TAIN 23
PROFESSIONAL LIABILITY INSURANCE COVERAGE; OR 24
(2) THE ASSISTED LIVING P ROGRAM’S PROFESSIONAL LIABI LITY 25
INSURANCE COVERAGE HAS LAPSED FOR ANY PERIOD OF TIME AND HAS NOT BEEN 26
RENEWED. 27
(B) THE NOTIFICATION UNDE R SUBSECTION (A) OF THIS SECTION SHAL L 28
BE: 29
(1) (I) PROVIDED TO A PROSPECTIVE RESIDENT: 30
HOUSE BILL 442 5
1. AT THE FIRST VISIT BY THE PROSPECTIVE RESIDENT 1
DURING ANY PERIOD IN WHICH AN ASSISTED LIVING PROGRAM DOES NOT MAINTAIN 2
PROFESSIONAL LIABILITY INSURANCE; AND 3
2. IF THE ASSISTED LIVIN G PROGRAM DOES NOT 4
MAINTAIN PROFESSIONAL LIABILITY INSURANCE AT THE TIME THE PROS PECTIVE 5
RESIDENT APPLIES FOR ADMISSION, AT THE TIME OF APPLICATION; AND 6
(II) IF THE PROFESSIONAL L IABILITY COVERAGE LA PSES, 7
PROVIDED TO EACH RES IDENT WITHIN 30 DAYS AFTER THE DATE THE COVERAGE 8
LAPSED; 9
(2) SIGNED BY: 10
(I) THE PROSPECTIVE RESID ENT AT THE TIME OF 11
APPLICATION FOR ADMISSION; OR 12
(II) THE RESIDENT AT THE T IME THE NOTIFICATION OF THE 13
LAPSE IN COVERAGE IS PROVIDED UNDER ITEM (1)(II) OF THIS SUBSECTION; AND 14
(3) RETAINED BY THE ASSIS TED LIVING PROGRAM AS PART OF T HE 15
ASSISTED LIVING PROGRAM’S RECORDS. 16
(C) EACH FACILITY–BASED ASSISTED LIVING PROGRAM IN THE STATE THAT 17
DOES NOT MAINTAIN PROFESSIONAL LIABILITY INSURANCE COVERAGE SHALL POST 18
A NOTIFICATION IN A CONSPICUOUS PLACE VI SIBLE TO RESIDENTS AND GUESTS 19
THAT THE ASSISTED LI VING PROGRAM DOES NO T MAINTAIN PROFESSIO NAL 20
LIABILITY INSURANCE. 21
Article – Health Occupations 22
8–604. 23
(A) EACH NURSE MIDWIFE PRACTICING AS A NURSE MIDWIFE IN THE STATE 24
SHALL NOTIFY A PATIE NT IN WRITING OR BY WRITTEN ELECTR ONIC 25
COMMUNICATION IF: 26
(1) THE NURSE MIDWIFE DOE S NOT MAINTAIN PROFE SSIONAL 27
LIABILITY INSURANCE COVERAGE; OR 28
(2) THE NURSE MIDWIFE ’S PROFESSIONAL LIABI LITY INSURANCE 29
COVERAGE HAS LAPSED FOR ANY PERIOD OF TIME AND HAS NOT BEEN RENEWED. 30
6 HOUSE BILL 442
(B) THE WRITT EN NOTIFICATION PROV IDED TO THE PATIENT UNDER 1
SUBSECTION (A) OF THIS SECTION SHALL BE: 2
(1) PROVIDED: 3
(I) AT THE FIRST VISIT BY THE PATIENT DURING T HE PERIOD 4
IN WHICH THE NURSE M IDWIFE DOES NOT MAIN TAIN PROFESSIONAL LI ABILITY 5
INSURANCE, UNLESS THE VI SIT IS FOR THE PURPO SE OF RECEIVING INCI DENTAL 6
MEDICAL CARE THAT WILL BE RENDERED FREE OF CHARGE; AND 7
(II) AS PART OF EACH INFORMED CONSENT OBTAINED BEFORE 8
ANY PROCEDURE DISCUSSED OR OFFERED FOR T HE PATIENT’S CONSIDERATION IS 9
PERFORMED; 10
(2) SIGNED BY THE PATIENT AT THE TIME OF THE PATIENT’S VISIT OR 11
AT THE TIME THE INFORMED CONSENT IS SIGNED; AND 12
(3) RETAINED BY THE NURSE MIDWIFE AS PART OF T HE NURSE 13
MIDWIFE’S PATIENT RECORDS. 14
(C) EACH NURSE MIDWIFE PRACTICING AS A NURSE MIDWIFE IN THE STATE 15
WHO DOES NOT MAINTAIN PROFESSIONAL LIABILITY INSURANCE COVERAGE SHALL 16
POST THIS INFORMATION IN A CONSPICUOUS L OCATION IN THE NURSE MIDWIFE’S 17
PLACE OF PRACTICE. 18
8–6D–15. 19
(A) EACH LICENSED CERTIFI ED MIDWIFE PRACTICIN G AS A LICENSED 20
CERTIFIED MIDWIFE IN THE STATE SHALL NOTIFY A PATIENT IN WRITING O R BY 21
WRITTEN ELECTRONIC COMMUNICATION IF: 22
(1) THE LICENSED CERTIFIE D MIDWIFE DOES NOT M AINTAIN 23
PROFESSIONAL LIABILITY INSURANCE COVERAGE; OR 24
(2) THE LICENSED CERTIFIE D MIDWIFE’S PROFESSIONAL LIABI LITY 25
INSURANCE COVERAGE HAS LAPSED FOR ANY PERIOD OF TIME AND HAS NOT BEEN 26
RENEWED. 27
(B) THE WRITTEN NOTIFICAT ION PROVIDED TO THE PATIENT UNDER 28
SUBSECTION (A) OF THIS SECTION SHALL BE: 29
(1) PROVIDED: 30
HOUSE BILL 442 7
(I) AT THE FIRST VISIT BY THE PATIENT DURING T HE PERIOD 1
IN WHICH THE LICENSED CERTIFIED MIDWIFE DOES NOT MAINTAIN PROFESSIONAL 2
LIABILITY INSURANCE , UNLESS THE VISIT IS FOR THE PURPOSE OF R ECEIVING 3
INCIDENTAL MEDICAL CARE THAT WILL BE RENDERED FREE OF CHARGE; AND 4
(II) AS PART OF EACH INFORMED CONSENT OBTAINED BEFORE 5
ANY PROCEDURE DISCUSSED OR OFFERED FOR T HE PATIENT’S CONSIDERATION IS 6
PERFORMED; 7
(2) SIGNED BY THE PATIENT AT THE TIME OF THE PATIENT’S VISIT OR 8
AT THE TIME THE INFORMED CONSENT IS SIGNED; AND 9
(3) RETAINED BY THE LICEN SED CERTIFIED MIDWIF E AS PART OF 10
THE LICENSED CERTIFIED MIDWIFE’S PATIENT RECORDS. 11
(C) EACH LICENSED CERTIFI ED MIDWIFE PRACTICIN G AS A LICENSED 12
CERTIFIED MIDWIFE IN THE STATE WHO DOES NOT MA INTAIN PROFESSIONAL 13
LIABILITY INSURANCE COVERAGE SHALL POST THIS INFORMATION IN A 14
CONSPICUOUS LOCATION IN THE LICE NSED CERTIFIED MIDWI FE’S PLACE OF 15
PRACTICE. 16
[8–6D–15.] 8–6D–16. 17
This subtitle may be cited as the Maryland Licensure of Certified Midwives Act. 18
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 19
October 1, 2026. 20
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.