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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb0971*
HOUSE BILL 971
J1 6lr1960
By: Delegates Woods, Fair, Hill, Ivey, Kaufman, J. Long, McComas, Patterson,
Roberson, Roberts, Ruff, Ruth, and Taveras
Introduced and read first time: February 6, 2026
Assigned to: Health
A BILL ENTITLED
AN ACT concerning 1
Maryland Medical Advisory Committee – Duties and Workgroup to Study the 2
Adoption of a Fee–for–Service Model for All Medicaid Services 3
FOR the purpose of requiring the Maryland Medical Advisory Committee to form 4
subcommittees and workgroups, as necessary, to carry out the duties of the 5
Committee; establishing the Workgroup to Study the Adoption of a Fee–for–Service 6
Model for All Medicaid Services to study the feasibility of implementing a direct care 7
payment model throughout the State’s Medicaid program; and generally relating to 8
the Maryland Medical Advisory Committee. 9
BY repealing and reenacting, without amendments, 10
Article – Health – General 11
Section 15–103(a) and (b)(1) 12
Annotated Code of Maryland 13
(2023 Replacement Volume and 2025 Supplement) 14
BY repealing and reenacting, with amendments, 15
Article – Health – General 16
Section 15–103(b)(27)(i) through (iv) 17
Annotated Code of Maryland 18
(2023 Replacement Volume and 2025 Supplement) 19
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21
Article – Health – General 22
15–103. 23
2 HOUSE BILL 971
(a) (1) The Secretary shall administer the Maryland Medical As sistance 1
Program. 2
(b) (1) As permitted by federal law or waiver, the Secretary may establish a 3
program under which Program recipients are required to enroll in managed care 4
organizations. 5
(27) (i) 1. The Department shall establish the Maryland Medicai d 6
Advisory Committee, composed of no more than 25 members. 7
2. The majority of the members of the Committee shall be 8
enrollees or enrollee advocates. 9
3. At least five members of the Committee shall be enrollees 10
representative of the entire Medicaid population. 11
(ii) The Committee members shall include: 12
1. At least five current or former enrollees or the parents or 13
guardians of current or former enrollees; 14
2. Providers who are familiar with the medical needs of 15
low–income population groups, including board–certified physicians; 16
3. Hospital representatives; 17
4. At least five but not more than 10 advocates for the 18
Medicaid population, including representatives of special needs populations, such as: 19
A. Children with special needs; 20
B. Individuals with physical disabilities; 21
C. Individuals with developmental disabilities; 22
D. Individuals with mental illness; 23
E. Individuals with brain injuries; 24
F. Medicaid and Medicare dual eligibles; 25
G. Individuals who are homeless or have experienced 26
homelessness; 27
H. Individuals enrolled in home – and community –based 28
services waivers; 29
HOUSE BILL 971 3
I. Elderly individuals; 1
J. Low–income individuals and individuals receiving 2
benefits through the Temporary Assistance for Needy Families Program; and 3
K. Individuals receiving substance abuse treatment services; 4
5. Two members of the Finance Committee of the Senate of 5
Maryland, appointed by the President of the Senate; and 6
6. Three members of the Maryland Ho use of Delegates, 7
appointed by the Speaker of the House. 8
(iii) A designee of each of the following shall serve as an ex –officio 9
member of the Committee: 10
1. The Secretary of Human Services; 11
2. The Executive Director of the Maryland Health Care 12
Commission; and 13
3. The Maryland Association of County Health Officers. 14
(iv) In addition to any duties imposed by federal law and regulation, 15
the Committee shall: 16
1. Advise the Secretary on the implementation, operation, 17
and evaluation of managed care programs under this section; 18
2. Review and make recommendations on the regulations 19
developed to implement managed care programs under this section; 20
3. Review and make recommendations on the standards used 21
in contracts between the Department and managed care organizations; 22
4. Review and make recommendations on the Department’s 23
oversight of quality assurance standards; 24
5. Review data collected by the Department from managed 25
care organizations participating in the Program and data collected by the Maryland Health 26
Care Commission; 27
6. Promote the dissemination of managed care organization 28
performance information, including loss ratios, to enrollees in a manner that facilitates 29
quality comparisons and uses layman’s language; 30
4 HOUSE BILL 971
7. Assist the Department in evaluating the enrollment 1
process; [and] 2
8. Review reports of the ombudsmen; AND 3
9. FORM WORKGROUPS AND S UBCOMMITTEES AS 4
NECESSARY TO CARRY OUT THE DUTIES OF THE COMMITTEE. 5
SECTION 2. AND BE IT FURTHER ENACTED, That: 6
(a) There is a Workgroup to Study the Adoption of a Fee –for–Service Model for 7
All Medicaid Services. 8
(b) The Workgroup consists of the following members: 9
(1) one member of the Senate of Maryland, appointed by the President of 10
the Senate; 11
(2) one member of the House of Delegates, appointed by the Speaker of the 12
House; 13
(3) one representative of the Maryland Health Care Commission , 14
appointed by the Chair of the Commission; and 15
(4) the following members, appointed by the Governor: 16
(i) one representative of Medicaid providers; 17
(ii) one representative of an advocacy organization that serves the 18
Medicaid population; and 19
(iii) any other member considered necessary by the Committee. 20
(c) The Maryland Medicaid Advisory Committee shall select the chair from 21
among the members of the Committee. 22
(d) The Maryland Medicaid Advisory Committee shall provide staff for the 23
Workgroup. 24
(e) A member of the Workgroup: 25
(1) may not receive compensation as a member of the Workgroup; but 26
(2) is entitled to reimbursement for expenses under the Standard State 27
Travel Regulations, as provided in the State budget. 28
(f) The Workgroup shall: 29
HOUSE BILL 971 5
(1) review the experience of Connecticut in delivering Medicaid through a 1
fee–for–service model, inclu ding the revenue saved by moving away from managed care 2
organizations and the impact of the model on overall cost of care, provider participation, 3
and overall access to services; 4
(2) review the State’s experience using fee–for–service instead of managed 5
care organizations to manage and pay for care, including ease of coordination for agencies 6
and providers; 7
(3) examine any other states that have implemented a fee –for–service 8
model o r are exploring a direct care model in their Medicaid programs in res ponse to 9
decreased funding and enrollment changes set forth in federal legislation or regulation; 10
(4) review any evidence –based studies on the benefits of a direct care 11
payment model in Medicaid programs, including to enrollees, to the State’s access to 12
real–time data, maintenance of provider networks, and other relevant outcomes; 13
(5) examine the feasibility of implementing a direct care payment model 14
throughout the State’s Medicaid program; and 15
(6) propose a potential timeline for the State’s tra nsition to a direct 16
payment model. 17
(g) On or before January 1, 2027 , the Workgroup shall report its findings and 18
recommendations to the Maryland Medicaid Advisory Committee and, in accordance with 19
§ 2–1257 of the State Government Article, the President of the Senate, the Speaker of the 20
House of Delegates, the Senate Finance Committee, and the House Health Committee. 21
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect July 22
1, 2026. Section 2 of this Act shall remain effective for a period of 1 year and, at the end of 23
June 30, 2027 , Section 2 of this Act, with no further action required by the General 24
Assembly, shall be abrogated and of no further force and effect. 25