MD State Updates - 2015 Jan 02 No.01

On May 12, 2015, Gov. Hogan signed SB 556 into law. The new law relates to conformity of Maryland law to PPACA. Among other changes, the law requires non-grandfathered insured plans to provide medically necessary treatment for mental illness, emotional disorders and drug and alcohol abuse. Treatment must include inpatient benefits for services provided in licensed or certified facilities (including hospital inpatient services), partial hospitalization benefits and outpatient benefits, including all office visits and psychological and neuropsychological testing for diagnostic purposes. Importantly, ‘partial hospitalization benefits’ means providing medically directed intensive or intermediate short-term treatment to plan participants in licensed or certified facilities or programs for mental illness, emotional disorders or drug and alcohol abuse for a period of more than four but less than 24 hours in a day. In addition, insurers may not charge copayments greater than 50 percent of the daily cost for methadone maintenance treatment.

The new law does not add compliance obligations for employers, but employers that sponsor fully insured plans should be aware of the new coverage requirements. The new law took effect May 12, 2015.

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