Committees in both chambers of the General Assembly are hearing testimony on a pair of bills to change how health insurance companies in Maryland make treatment coverage decisions. What’s known as 'utilization review' is a process that can be time-consuming and opaque, with criteria that may be set by the insurance company instead of clinical standards. The Senate Finance Committee heard testimony Wednesday on S-B 791, which would require insurers to use expert nonprofit clinical guidelines to make coverage decisions. David Lloyd, with the mental health advocacy organization 'Inseparable,' says these bills will remove barriers to care.

"It puts in place important patient protections to help people get the care they need for their mental health and substance use conditions."

Testimony on the companion bill will be heard in the House Health and Government Operations Committee on Thursday.

The bills would ensure patients can remain on a drug if it has been authorized in the past, and can keep existing drug coverage for 90 days if they change insurance companies. The bills would also require insurers to establish a real-time benefits check, where prescribers can view an electronic health record to see insurance coverage, drug costs and more. Lloyd says this should speed up the authorization process, which can be slow – and harmful to people in crisis.

"Particularly for people who are struggling with mental health or substance use challenges, these types of barriers can be really harmful, and can make it so that they don't ultimately get the treatments that are critical for their well-being."

If passed, the electronic health record system would be required to begin by July of 2026.

Committees in both chambers of the General Assembly are hearing testimony on a pair of bills to change how health insurance companies in Maryland make treatment coverage decisions.