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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1251*
HOUSE BILL 1251
J5, J3, J1 6lr2987
By: Delegates Woods, Alston, J. Long, and Turner
Introduced and read first time: February 12, 2026
Assigned to: Health
A BILL ENTITLED
AN ACT concerning 1
Health Facilities and Health Insurance – Palliative Care – Required Access and 2
Coverage 3
(Edna G. Neal Palliative Care Act) 4
FOR the purpose of requiring that, on or after a certain date , certain facilities provide 5
patients with certain access to palliative care and inform patients about the 6
availability of palliative care at certain times; requiring certain insurers, nonprofit 7
health service plans, and health maintenance organizations to provide health 8
insurance coverage for certain palliative care; prohibiting certain insurers, nonprofit 9
health service plans, and health maintenance organizations from imposing certain 10
copayments, coinsurance, or deductible requirements on coverage for palliative care; 11
and generally relating to palliative care. 12
BY adding to 13
Article – Health – General 14
Section 19 –2701 through 19 –2703 to be under the new subtitle “Subtitle 27. 15
Palliative Care” 16
Annotated Code of Maryland 17
(2023 Replacement Volume and 2025 Supplement) 18
BY adding to 19
Article – Insurance 20
Section 15–864 21
Annotated Code of Maryland 22
(2017 Replacement Volume and 2025 Supplement) 23
Preamble 24
WHEREAS, Serious illnesses such as cancer, sickle cell disease, heart disease, 25
advanced lung disease, neurological disorders, and other chronic or life–limiting conditions 26
affect thousands of State residents each year; and 27
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WHEREAS, Patients facing serious illnesses often endure significant pain, physical 1
distress, and emotional hardship, which also deeply impact their families and caregivers ; 2
and 3
WHEREAS, Palliative care is an evidence–based medical specialty that improves the 4
quality of life for patients and families by providing relief from pain, symptoms, and stress 5
while respecting patient dignity, culture, and personal values; and 6
WHEREAS, Studies have demonstrated that palliative care not only enhances 7
patient well–being but also reduces unnecessary hospitalizations and health care costs; and 8
WHEREAS, Despite the benefits, access to pallia tive care remains inconsistent 9
across the State, leaving many patients without adequate support during critical stages of 10
illness; and 11
WHEREAS, Health equity requires that all State residents, regardless of age, race, 12
income, or insurance status, have access to comprehensive palliative care services; and 13
WHEREAS, It is in the best interest of the State to guarantee statewide access to 14
palliative care as a standard component of medi cal care, mandate insurance coverage for 15
palliative c are services without discrimination or financial barriers, and ensure that 16
patients and families are fully informed of their right to receive palliative care; and 17
WHEREAS, The State intends to honor th e legacy of Edna G. Neal by advancing 18
compassionate, person–centered care throughout the State; now, therefore, 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
SUBTITLE 27. PALLIATIVE CARE. 23
19–2701. 24
(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 25
INDICATED. 26
(B) “FACILITY” MEANS A HOSPITAL , NURSING HOME , HOSPICE CARE 27
FACILITY, OR OTHER LONG–TERM CARE FACILITY LICENSED IN THE STATE. 28
(C) “PALLIATIVE CARE ” MEANS SPECIALIZED MEDICAL CARE FOR 29
INDIVIDUALS LIVING WITH SERIOUS ILLNESS THAT IS FOCUSED ON PROVIDING 30
RELIEF FROM SYMPTOMS, PAIN, AND STRESS, REGARDLESS OF DIAGNOSIS OR STAGE 31
HOUSE BILL 1251 3
OF DISEASE , WITH THE GOAL OF IMP ROVING QUALITY OF LI FE FOR BOTH THE 1
PATIENT AND THE PATIENT’S FAMILY. 2
19–2702. 3
(A) ON OR AFTER OCTOBER 1, 2027, EACH FACILITY SHALL: 4
(1) PROVIDE PATIENTS WITH ACCESS TO A DEDICATE D PALLIATIVE 5
CARE PROGRAM; 6
(2) ENSURE THAT PALLIATIVE CARE IS AVAILABLE AS A TREATMENT 7
OPTION ALONGSIDE CURATIVE OR LIFE–PROLONGING TREATMENTS; AND 8
(3) AS APPROPRIATE , INFORM PATIENTS AND T HEIR FAMILIES OF 9
THE AVAILABILITY OF PALLIATIVE CARE SERVICES AT THE TIME OF DIAGNOSIS OF A 10
SERIOUS ILLNESS, DURING TREATMENT PLANNING, AND AT THE TIME OF HOSPITAL 11
ADMISSION. 12
(B) THE DEPARTMENT SHALL ADOPT REGULATI ONS ESTABLISHING 13
MINIMUM STANDARDS FO R THE DELIVERY OF PA LLIATIVE CARE , INCLUDING 14
STAFFING, TRAINING, AND QUALITY ASSURANCE REQUIREMENTS. 15
19–2703. 16
ON OR BEFORE JANUARY 1 EACH YEAR , BEGINNING IN 2028, THE 17
DEPARTMENT SHALL REPORT TO THE GENERAL ASSEMBLY, IN ACCORDANCE WITH 18
§ 2–1257 OF THE STATE GOVERNMENT ARTICLE, ON ACCESS, UTILIZATION, AND 19
QUALITY OF PALLIATIVE CARE SERVICES PROVIDED IN THE STATE. 20
SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 21
as follows: 22
Article – Insurance 23
15–864. 24
(A) IN THIS SECTION, “PALLIATIVE CARE” HAS THE MEANING STATED IN § 25
19–2701 OF THE HEALTH – GENERAL ARTICLE. 26
(B) THIS SECTION APPLIES TO: 27
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 28
PROVIDE HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS 29
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ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 1
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE; AND 2
(2) HEALTH MAINTENANCE ORGANIZA TIONS THAT PROVIDE 3
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GROUPS UNDER 4
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE. 5
(C) (1) AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE 6
COVERAGE FOR PALLIATIVE CARE, INCLUDING THE FOLLOWING SERVICES AS THEY 7
RELATE TO PALLIATIVE CARE: 8
(I) PHYSICIAN AND NURSING SERVICES; 9
(II) COUNSELING AND MENTAL HEALTH SERVICES; 10
(III) PAIN MANAGEMENT AND SYMPTOM RELIEF; 11
(IV) HOME–BASED AND COMMUNITY–BASED CARE; AND 12
(V) SOCIAL WORK, CARE COORDINATION, AND FAMILY 13
SUPPORT SERVICES. 14
(2) THE COVERAGE REQUIRED UNDER PARAGRAPH (1) OF THIS 15
SUBSECTION MAY NOT BE: 16
(I) DENIED BECAUSE A PATIENT IS CONTINUING CURATIVE 17
TREATMENT; OR 18
(II) LIMITED TO END–OF–LIFE CARE. 19
(D) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 20
AN ENTITY SUBJECT TO THIS SECTION MAY NOT IMPOSE A COPAYMENT , 21
COINSURANCE, OR DEDUCTIBLE REQUIR EMENT ON COVERAGE FO R PALLIATIVE 22
CARE THAT IS GREATER THAN THE COPAY , COINSURANCE, OR DEDUCTIBLE 23
REQUIREMENT FOR OTHER COMPARABLE MEDICAL SERVICES. 24
(2) IF AN INSURED OR ENRO LLEE IS COVERED UNDE R A 25
HIGH–DEDUCTIBLE HEALTH PL AN, AS DEFINED IN 26 U.S.C. § 223, AN ENTITY 26
SUBJECT TO THIS SECT ION MAY SUBJECT PALLIATIVE CARE TO THE DEDUCTIBLE 27
REQUIREMENT OF THE HIGH–DEDUCTIBLE HEALTH PLAN. 28
SECTION 3. AND BE IT FURTHER ENACTED, That Section 1 of this Act may not 29
be construed to prevent a facility from providing access to palliative care before October 1, 30
2027. 31
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SECTION 4. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall 1
apply to all policies, contracts, and health benefit plans issued, delivered, or renewed in the 2
State on or after January 1, 2027. 3
SECTION 5. AND BE IT FURTHER ENACTED, That Section 2 of this Act shall take 4
effect January 1, 2027. 5
SECTION 6. AND BE IT FURTHER ENACTED, That, except as provided in Section 6
5 of this Act, this Act shall take effect October 1, 2026. 7