Maryland Medical Assistance Program - Coverage for the Treatment of Obesity - Authorization

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
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*sb0496*

SENATE BILL 496
J1 (6lr2703)
ENROLLED BILL
— Finance/Health —
Introduced by Senator Hershey Senators Hershey and Lam

Read and Examined by Proofreaders:

_______________________________________________
Proofreader.
_______________________________________________
Proofreader.

Sealed with the Great Seal and presented to the Governor, for his approval this

_______ day of _______________ at _________________ _______ o’clock, ________M.

______________________________________________
President.

CHAPTER ______

AN ACT concerning 1

Maryland Medical Assistance Program – Coverage for the Treatment of 2
Obesity – Authorization 3

FOR the purpose of authorizing, beginning on a certain date, the Maryland Medical 4
Assistance Program to provide comprehensive coverage for the treatment of obesity; 5
requiring the Maryland Department of Health to provide notice to Program 6
recipients if the Department elects to provide the coverage; authorizing the 7
Maryland Department of Health to apply to the Centers for Medicare and Medicaid 8
Services for a State plan amendment authorizing the State to provide comprehensive 9
coverage for the treatment of obesity; and generally relating to the Maryland Medical 10
Assistance Program and coverage for the treatment of obesity. 11

BY repealing and reenacting, without amendments, 12
Article – Health – General 13
Section 15–103(a)(1) 14
2 SENATE BILL 496

Annotated Code of Maryland 1
(2023 Replacement Volume and 2025 Supplement) 2

BY repealing and reenacting, with amendments, 3
Article – Health – General 4
Section 15–103(a)(2)(xxvii) and (xxviii) 5
Annotated Code of Maryland 6
(2023 Replacement Volume and 2025 Supplement) 7

BY adding to 8
Article – Health – General 9
Section 15–103(a)(2)(xxix) and 15–160 10
Annotated Code of Maryland 11
(2023 Replacement Volume and 2025 Supplement) 12

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 13
That the Laws of Maryland read as follows: 14

Article – Health – General 15

15–103. 16

(a) (1) The Secretary shall administer the Maryland Medical Assistance 17
Program. 18

(2) The Program: 19

(xxvii) Beginning on January 1, 2026, if providing coverage for 20
the delivery of anesthesia, shall provide coverage for the delivery of anesthesia in 21
accordance with § 15–862 of the Insurance Article; [and] 22

(xxviii) Beginning on January 1, 2026, shall provide calcium score 23
testing in accordance with § 15–863 of the Insurance Article; AND 24

(XXIX) BEGINNING ON JANUARY 1, 2027, MAY PROVIDE 25
COMPREHENSIVE COVERAGE FOR THE TREATMENT OF OBESITY UNDER § 15–160 OF 26
THIS SUBTITLE. 27

15–160. 28

(A) IN THIS SECTION, “COMPREHENSIVE COVERAGE FOR THE TREATMENT 29
OF OBESITY ” INCLUDES COVERAGE FO R INTENSIVE BEHAVIOR AL THERAPY , 30
BARIATRIC SURGERY , AND ANY MEDICATION A PPROVED BY THE FEDER AL FOOD 31
AND DRUG ADMINISTRATION WITH A N INDICATION FOR CHR ONIC WEIGHT 32
MANAGEMENT IN PATIENTS WITH OBESITY. 33

SENATE BILL 496 3

(B) THE PROGRAM MAY PROVIDE C OMPREHENSIVE COVERAGE FOR THE 1
TREATMENT OF OBESITY. 2

(C) THE PROGRAM MAY UNDERTAKE UTILIZATION MANAGEME NT TO 3
DETERMINE THE MEDICAL NECESSITY AND APPROPRIATENESS FOR TREATMENT OF 4
OBESITY UNDER THIS SECTION IF THE DETERMINATIONS ARE M ADE IN THE SAME 5
MANNER AS DETERMINAT IONS ARE MADE FOR TH E TREATMENT OF ANY O THER 6
ILLNESS, CONDITION, OR DISORDER COVERED BY THE PROGRAM. 7

(D) IF THE DEPARTMENT ELECTS TO PROVIDE COMPREHENSIVE COVERAGE 8
FOR THE TREATMENT OF OBESITY UNDER THIS SECTION, THE DEPARTMENT SHALL 9
PROVIDE NOTICE TO PROGRAM RECIPIENTS. 10

SECTION 2. AND BE IT FURTHER ENACTED, That the Maryland Department of 11
Health may apply to the Centers for Medicare and Medicaid Services for a State plan 12
amendment that authorizes the State to provide comprehensive coverage for the treatment of 13
obesity. 14

SECTION 3. AND BE IT FURTHER ENACTED, That , on or before November 1, 15
2027, the Maryland Department of Health shall report to the Senate Finance Committee, 16
the Senate Budget and Taxation Committee, the House Health Committee, and the House 17
Appropriations Committee, in accordance with § 2 –1257 of the State Government Article, 18
on whether the Maryland Medical Assistance Program has begun to provide comprehensive 19
coverage for the treatment of obesity as authorized under § 15–160 of the Health – General 20
Article, as enacted by Section 1 of this Act, and if not, why the Department has not begun 21
to provide coverage. 22

SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall take effect 23
October 1, 2026. 24

Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.