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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1157*
HOUSE BILL 1157
J5 6lr2533
CF SB 774
By: Delegates Guzzone, Hill, Lehman, Qi, Taveras, Watson, and Woods
Introduced and read first time: February 11, 2026
Assigned to: Health
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Plan Benefits and Coverage – Annual Reporting 2
(Transparency, Reporting, Understanding, Timeliness, and Honesty 3
(TRUTH) in Mental Health Coverage Act) 4
FOR the purpose of requiring each carrier that provides a health benefit plan in the State 5
to report certain data regarding claims and coverage to the Maryland Insurance 6
Commissioner using a certain template; requiring the Commissioner to develop a 7
template for carriers to r eport the data and make the data publicly available by 8
posting certain data on a public website and developing and maintaining certain data 9
dashboards; authorizing the Commissioner to adopt regulations to establish 10
regulatory fees or assessments to cover t he costs of implementing this Act; and 11
generally relating to health benefit plans issued in the State. 12
BY adding to 13
Article – Insurance 14
Section 15 –2201 through 15 –2208 to be under the new subtitle “Subtitle 22. 15
Transparency, Reporting, Understanding, Timeliness, and Honesty in Mental 16
Health Coverage” 17
Annotated Code of Maryland 18
(2017 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 – Insurance 22
SUBTITLE 22. TRANSPARENCY, REPORTING, UNDERSTANDING, TIMELINESS, AND 23
HONESTY IN MENTAL HEALTH COVERAGE. 24
15–2201. 25
2 HOUSE BILL 1157
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 1
INDICATED. 2
(B) “BEHAVIORAL HEALTH CAR E SERVICES ” MEANS MENTAL HEALTH 3
DISORDER CARE SERVICES AND SUBSTANCE USE DISORDER CARE SERVICES. 4
(C) “CARRIER” HAS THE MEANING STATED IN § 15–144 OF THIS TITLE. 5
(D) (1) “FACILITY TYPE” MEANS THE CATEGORY OF FACILITY AND LEVEL 6
OF CARE IN WHICH SERVICES ARE PROVIDED. 7
(2) “FACILITY TYPE” INCLUDES: 8
(I) OUTPATIENT FACILITIE S, INCLUDING INTENSIVE 9
OUTPATIENT AND PARTIAL HOSPITALIZATION SERVICES; 10
(II) ACUTE INPATIENT FACILITIES; AND 11
(III) SUB–ACUTE INPATIENT FACI LITIES, INCLUDING 12
RESIDENTIAL CARE FACILITIES OR SKILLED NURSING FACILITIES. 13
(E) “HEALTH BENEFIT PLAN ” HAS THE MEANING STAT ED IN § 15–144 OF 14
THIS TITLE. 15
(F) “MEDICAL OR SURGICAL S ERVICES” MEANS ANY HEALTH CAR E 16
SERVICES OR BENEFITS THAT ARE NOT MENTAL HEALTH OR SUBSTANCE USE CARE 17
SERVICES. 18
(G) “MENTAL HEALTH SERVICES” MEANS SERVICES OR BENEFITS FOR THE 19
DIAGNOSIS OR TREATME NT OF MENTAL HEALTH DISORDERS OTHER THAN 20
SUBSTANCE USE DISORD ERS, AS CLASSIFIED IN THE MENTAL AND BEHAVIORA L 21
DISORDERS CHAPTERS OF THE INTERNATIONAL CLASSIFICATION OF DISEASES AND 22
THE MENTAL DISORD ER DIAGNOSTIC CATEGO RIES OF THE DIAGNOSTIC AND 23
STATISTICAL MANUAL OF MENTAL DISORDERS. 24
(H) “PLAN LEVEL ” MEANS THE STANDARDIZ ED SYSTEM CLASSIFYIN G 25
HEALTH CARE PLANS BASED ON THE COST–SHARING STRUCTURE. 26
(I) (1) “PROVIDER TYPE ” MEANS THE CATEGORY O F HEALT H CARE 27
SERVICES THAT A HEALTH CARE PROFESSIONAL PROVIDES. 28
(2) “PROVIDER TYPE” INCLUDES: 29
HOUSE BILL 1157 3
(I) PSYCHIATRISTS; 1
(II) NURSE PRACTITIONERS IDENTIFIED BY SPECIA LTY, 2
INCLUDING PSYCHIATRIC NURSE PRACTITIONERS; 3
(III) PHYSICIAN ASSISTANTS IDENTIFIED BY SPECIALTY, 4
INCLUDING PSYCHIATRIC PHYSICIAN ASSISTANTS; 5
(IV) PSYCHOLOGISTS; 6
(V) OTHER INDEPENDENTLY LICENSED BEHAVIORAL HEALTH 7
PROVIDERS; 8
(VI) PRIMARY CARE PHYSICIANS; AND 9
(VII) SPECIALIST PHYSICIAN S, INCLUDING SURGICAL 10
PHYSICIANS. 11
(J) “SUBSTANCE USE SERVICES” MEANS SERVICES OR BENEFITS PROVIDED 12
FOR THE DIAGNOSIS AN D TREATMENT OF SUBST ANCE USE DISORDERS , AS 13
CLASSIFIED IN THE MO ST CURRENT VERSIONS OF THE INTERNATIONAL 14
CLASSIFICATION OF DISEASES AND THE DIAGNOSTIC AND STATISTICAL MANUAL 15
OF MENTAL DISORDERS. 16
(K) “UTILIZATION REVIEW” MEANS THE PROSPECTIV E, CONCURRENT, OR 17
RETROSPECTIVE REVIEW OF THE MEDICAL NECES SITY AND APPROPRIATENESS OF 18
A TREATMENT OR RESOU RCE ALLOCATION TO AN ENROLLEE OR GROUP OF 19
ENROLLEES. 20
15–2202. 21
(A) ON OR BEFORE MARCH 1 EACH YEAR , BEGINNING IN 2028, EACH 22
CARRIER THAT PROVIDE S A HEALTH BENEFIT P LAN SUBJECT TO INSUR ANCE 23
REGULATION IN THE STATE SHALL: 24
(1) REPORT TO THE COMMISSIONER THE FOLLOWING INFORMATION 25
ON THE TEMPLATE DEVELOPED BY THE COMMISSIONER UNDER § 15–2203 OF THIS 26
SUBTITLE: 27
(I) CLAIMS DATA SUFFICIE NT TO EVALUATE , FOR EACH 28
FACILITY TYPE AND PROVIDER TYPE, ACCESS TO AND COVERAGE OF: 29
4 HOUSE BILL 1157
1. MENTAL HEALTH SERVICES; 1
2. SUBSTANCE USE SERVICES; 2
3. BEHAVIORAL HEALTH SERVICES; 3
4. MEDICAL OR SURGICAL SERVICES; 4
5. YOUTH AND ADULT SERV ICES, SEPARATELY AND 5
COMBINED; 6
6. IN–PERSON AND TELEHEALT H SERVICES , 7
SEPARATELY AND COMBINED; AND 8
7. GEOGRAPHIC AREA , AS SPECIFIED BY THE 9
COMMISSIONER; 10
(II) WHETHER THE FACILITY OR PROFESSIONAL HEALTH CARE 11
PROVIDER IS AFFILIAT ED WITH , OWNED BY , OR UNDER COMMON CONT ROL WITH 12
THE CARRIER, AS SPECIFIED BY THE COMMISSIONER; AND 13
(III) CLAIMS DATA , DISAGGREGATED BY FAC ILITY TYPE , 14
PROVIDER TYPE, YOUTH ENROLLEES, ADULT ENROLLEES, IN–PERSON VISITS, AND 15
TELEHEALTH VISITS, SUFFICIENT TO EVALUATE: 16
1. NETWORK ACCURACY , AVAILABILITY, AND 17
PARTICIPATION, INCLUDING WHETHER PR OVIDERS LISTED AS IN –NETWORK ARE 18
AVAILABLE TO PROVIDE COVERED SERVICES TO ENROLLEES; 19
2. NETWORK SIZE AND COM POSITION, INCLUDING THE 20
SIZE OF CARRIER NETW ORKS RELATIVE TO THE AVAILABLE SUPPLY OF 21
STATE–LICENSED HEALTH CARE PROVIDERS; 22
3. NETWORK ADMISSION AN D CONTRACTING 23
PRACTICES, INCLUDING PRACTICES RELATING TO PROVIDER CREDENTIALING, 24
CONTRACTING, AND EFFECTIVE PARTICIPATION IN CARRIER NETWORKS; 25
4. IN–NETWORK REIMBURSEMEN T, INCLUDING 26
IN–NETWORK REIMBURSEMEN T LEVELS AND PAYMENT DISTRIBUTIONS FOR 27
COVERED SERVICES, AND COMPARISON TO ONE OR MORE EXTERNAL BENCHMARKS, 28
AS DETERMINED BY THE COMMISSIONER; 29
HOUSE BILL 1157 5
5. OUT–OF–NETWORK UTI LIZATION, INCLUDING THE 1
EXTENT TO WHICH COVE RED SERVICES ARE FUR NISHED AND REIMBURSE D AT 2
OUT–OF–NETWORK BENEFIT LEVELS; 3
6. ACCESS TO EVIDENCE –BASED BEHAVIORAL HEA LTH 4
CARE DELIVERY MODELS , INCLUDING ACCESS TO AND UTILIZATION OF 5
PSYCHIATRIC COLLABOR ATIVE CARE AND OTHER EV IDENCE–BASED MODELS , AS 6
DETERMINED BY THE COMMISSIONER; AND 7
7. ANY ADDITIONAL METRI CS THE COMMISSIONER 8
DETERMINES NECESSARY FOR PUBLIC COMPARISO N AND OVERSIGHT , INCLUDING 9
THOSE RELATED TO ACC ESS TO TIMELY , CLINICALLY APPROPRIA TE C ARE, 10
UTILIZATION REVIEW , NETWORK ADEQUACY , REIMBURSEMENT EQUITY , OR 11
COMPLIANCE WITH FEDERAL OR STATE; AND 12
(2) SUBMIT A CERTIFICATI ON SIGNED BY THE CAR RIER’S CHIEF 13
FINANCIAL OFFICER UNDER PENALTY OF PERJU RY STATING THAT THE REPORTED 14
DATA ARE COMPLETE AND ACCURATE AND CALCULATIONS FOLLOW THE TEMPLATE 15
DEFINITIONS AND INSTRUCTIONS. 16
(B) THE DATA REPORTED IN ACCORDANCE WITH SUBSECTION (A) OF THIS 17
SECTION IS NOT PROPRIETARY OR CONFIDENTIAL BUT IS SUBJECT TO THE CENTERS 18
FOR MEDICARE AND MEDICAID SERVICES CELL SUPPRESSION STANDARD S, 19
INCLUDING FOR PURPOS ES OF MAKING THE DAT A PUBLICLY AVAILABLE AS 20
REQUIRED UNDER § 15–2204 OF THIS SUBTITLE. 21
15–2203. 22
(A) THE COMMISSIONER SHALL DE VELOP A UNIFORM TEMP LATE FOR 23
CARRIERS TO REPORT T HE INFORMATION REQUI RED UNDER § 15–2202(A)(1) OF 24
THIS SUBTITLE. 25
(B) IN DEVELOPING THE REP ORTING TEMPLATE , THE COMMISSIONER 26
SHALL REVIEW AND CONSIDER FORMATS THAT ARE: 27
(1) USED BY INSURANCE REGULATORS IN OTHER STATES; 28
(2) ENDORSED AND USED BY ONE OR MORE EMPLOYER COALITIONS, 29
HUMAN RESOURCES ASSOCIATIO NS, OR MENTAL HEALTH NON PROFIT 30
ORGANIZATIONS; OR 31
(3) CITED BY THE FEDERAL DEPARTMENT OF LABOR OR FEDERAL 32
DEPARTMENT OF HEALTH AND HUMAN SERVICES. 33
6 HOUSE BILL 1157
(C) (1) THE COMMISSIONER SHALL EN SURE COMPARABILITY A CROSS 1
CARRIERS BY ADOPTING UNIFORM TEMPLATES, DEFINITIONS, AUDIT PROCEDURES, 2
AND CORRECTION PROTOCOLS. 3
(2) THE COMMISSIONER MAY REFI NE, GROUP, STRATIFY, OR NOT 4
INCLUDE DIAGNOSTIC C ATEGORIES OR CONDITI ONS WITHIN MENTAL HE ALTH OR 5
SUBSTANCE USE DISORD ER BENEFITS TO ENSUR E MEANINGFUL, ACCURATE, AND 6
COMPARABLE PUBLIC REPORTING. 7
(3) THE COMMISSIONER MAY SATI SFY REPORTING REQUIR EMENTS 8
UNDER THIS SUBTITLE USING DATA COLLECTED OR MAINTAINED BY THE 9
ADMINISTRATION FOR OT HER PURPOSES , PROVIDED THAT THE COMMISSIONER 10
MAKES THE DATA USED AVAILABLE IN ACCORDANCE WITH § 15–2204 OF THIS 11
SUBTITLE. 12
15–2204. 13
NOT LATER THAN 3 MONTHS AFTER RECEIVI NG DATA REQUIRED TO BE 14
REPORTED UNDER § 15–2202(A)(1) OF THIS SUBTITLE, THE COMMISSIONER SHALL 15
MAKE THE DATA PUBLICLY AVAILABLE BY: 16
(1) DEVELOPING AND MAIN TAINING AN INTERACTI VE VIRTUAL 17
DASHBOARD TO VISUALLY PRESENT THE COLLECTED DATA THAT: 18
(I) INCLUDES A SEPARATE DISPLAY OF ADULT OUTCOMES AND 19
OUTCOMES FOR INDIVIDUALS UNDER THE AGE OF 18 YEARS; AND 20
(II) ALLOWS COMPARISONS B ETWEEN PLANS , CARRIERS, AND 21
PLAN LEVELS; AND 22
(2) POSTING THE DATA IN AN EASILY ACCESSIBLE , 23
CONSUMER–FRIENDLY MANNER ON A PUBLIC WEBSITE THAT INCLUDES 24
DOWNLOADABLE FILES SUFFICIENT TO ALLOW P UBLIC ANALYSIS, RESEARCH, AND 25
INDEPENDENT COMPARISON. 26
15–2205. 27
(A) THE COMMISSIONER MA Y ADOPT REGULATIONS TO ESTABLISH 28
REGULATORY FEES OR A SSESSMENTS ON CARRIE RS TO RECOVER THE CO STS OF 29
IMPLEMENTING THIS SU BTITLE, INCLUDING MAINTAININ G THE DASHBOARD 30
REQUIRED UNDER § 15–2204(1) OF THIS SUBTITLE. 31
HOUSE BILL 1157 7
(B) FEES AND ASSESSMENTS COLLECTED UNDER THIS SECTION: 1
(1) SHALL BE DEPOSITED INTO THE INSURANCE REGULATION FUND 2
ESTABLISHED UNDER § 2–505 OF THIS ARTICLE; AND 3
(2) MAY BE USED ONLY FOR THE PURPOSES SPECIFI ED IN 4
SUBSECTION (A) OF THIS SECTION. 5
15–2206. 6
(A) THE FAILURE TO SUBMIT TIMELY, COMPLETE, OR ACCURATE DATA 7
CONSTITUTES AN UNFAI R OR DECEPTIVE ACT O R PRACTICE UNDER TITLE 27 OF 8
THIS ARTICLE. 9
(B) THE COMMISSIONER MAY REFE R A CARRIER THAT FAI LS TO COMPLY 10
WITH THE REQUIREMENT S OF THIS SUBTITLE T O THE ATTORNEY GENERAL FOR 11
INVESTIGATION OR CIVIL ACTION. 12
15–2207. 13
THE COMMISSIONER MAY ADOP T REGULATIONS TO CAR RY OUT THIS 14
SUBTITLE. 15
15–2208. 16
THIS SUBTITLE MAY BE CITED AS THE TRANSPARENCY, REPORTING, 17
UNDERSTANDING, TIMELINESS, AND HONESTY (TRUTH) IN MENTAL HEALTH 18
COVERAGE ACT. 19
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 20
January 1, 2027. 21