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Health law checkup: New measures to expand behavioral health, transgender care take effect


Health law checkup: New measures to expand behavioral health, transgender care take effect

Oct 03, 2023 | 7:00 am ET
By Danielle J. Brown
Health law checkup: New measures to expand behavioral health, transgender care take effect
Gov. Wes Moore (D) signed hundreds of bills into law after the 2023 General Assembly session, including several bills to expand health care access in the state. File photo by Bryan P. Sears.

In the new administration’s first year, Gov. Wes Moore (D) and the state’s top lawmakers supported legislation to bolster health care coverage, access and protections in Maryland.

Moore signed several bills back in May that aim to do just that. Some of those bills, including measures to protect and expand access to abortion services, took effect in June. But several health-care focused bills went into effect over the weekend, with a start date of Oct.1.

Those bills, now law, could have a far-reaching effect on the health care system in the state, from information-gathering councils and work groups, to a broad mandate creating a network for improved behavioral health services, to protections for transgender-focused health care.

The new laws may also serve as a jumping off point for additional health-focused bills that will be considered in the upcoming 2024 legislative session.

“I think you see a framework of a change in direction in how we’re going to be doing things in Annapolis. I think you’re going to see more proactive health policies going forward. I think this first year is kind of a building year,” said Gene Ransom, CEO of MedChi, the Maryland State Medical Society.

Here’s a recap of new health care related laws that took effect this week:

Behavioral health

Ransom is particularly encouraged by the bundle of bills aiming to set up a network to better tackle behavioral health in Maryland.

“I think by far the behavioral health bills were really, really important, because they are a good first step to a major problem. And these were both very positive steps in the right direction,” he said.

A wide-reaching behavioral health bill establishes a new commission on behavioral health care treatment and access, which is tasked with making recommendations to create stronger access for on-demand behavioral health services.

The commission will be composed of legislators, officials from state agencies, people directly affected by behavioral health services and medical experts.

The commission will conduct an analysis of behavioral health services across the state to identify gaps in services and provide recommendations how to address those gaps. The commission will also focus on helping specific groups, including geriatric residents, youth and individuals with disabilities, and targeting criminal justice-involved behavioral health services.

The bill also extends provisions in state law that allow telehealth services to be treated in same manner as if the services were delivered in person when it comes to reimbursing providers.

The expiration date for this provision was extended from 2023 to at least 2025, and the Maryland Health Care Commission will also be conducting a study on the delivery of health care services through telehealth and make recommendations to the General Assembly

The new law also sets up a pilot program to apply “value-based” reimbursements, which are meant to incentivize providers to achieve favorable patient outcomes, rather than rewarding quantity of services. The General Assembly provided $600,000 annually to this three-year pilot program, with more funds contingent on the success of the pilot program.

Even with the wide-reaching behavioral health bill, Ransom said there are still “major access problems” and other ways behavioral health can improve in Maryland, which may be addressed in the upcoming session.

“We have a lot more work to do on behavioral health,” he said.

Trans Health Equity Act

The “Trans Health Equity Act,” which will expand Medicaid coverage in Maryland so that low-income transgender Marylanders can receive gender-affirming care.

The additional gender-affirming care coverage includes a variety of procedures and services, including voice training, hormone therapy, puberty blockers, and several cosmetic and surgical alterations for the face and body. The Trans Health Equity Act requires that the services are “medically necessary treatment consistent with current clinical standards of care prescribed by a licensed health care provider.”

The new law means that gender-affirming services cannot be denied on the basis that “the treatment is a cosmetic service.”

The Trans Health Equity Act also requires health care companies to report to the Maryland Department of Health information on the gender-affirming treatments they provided throughout the year.

Expanding access to care

To expand access to Medicaid and other federal health care programs, the General Assembly passed a bill to prompt the Maryland Department of Health to establish an “express lane eligibility” program that enrolls people in Medicaid and the Maryland Children’s Health Program based on an individual’s established eligibility of Supplemental Nutrition Assistance Program, which are sometimes referred to as “food stamps.”

Vincent DeMarco, president of Maryland Health Care for All Coalition, said the new law will “make it easy for the state to make sure that participants in the SNAP… who are eligible for Medicaid have health coverage.”

DeMarco argued that the easier enrollment process will help low-income Marylanders maintain health care coverage, especially as the state is working through thousands of Medicaid redeterminations in a process called “Medicaid unwinding” as protections from the COVID-19 global health emergency expire.

Federal officials warn of ‘inappropriate’ Medicaid terminations; Maryland, other states told to review redetermination process

Rare disease workgroup

House Bill 302/Senate Bill 188 sets up a rare disease advisory council, which will include lawmakers, health insurance and industry representatives, medical experts who deal with rare diseases and people who have been diagnosed with rare diseases or are close to a rare disease patient.

The council is tasked with surveying people living with rare diseases and their care givers and health care providers to identify the needs of this population in Maryland. Their findings will then be delivered to the governor and General Assembly, with recommendations to expand care coverage in the future.