Mid-Atlantic Health Law TOPICS

The Maryland General Assembly may have adjourned early this year, but during the short legislative session, a number of new health care laws were passed. Following are summaries of some legislation that will impact health care providers and health insurers in Maryland:

Dentistry

While the trend nationwide is to permit non-licensed individuals to own companies that provide medical and other health care services, that trend is being bucked in Maryland — at least in regard to dentistry. As of October 1, 2020, a dental practice may only be owned by a company solely owned by one or more individuals licensed to practice dentistry, and licensed individuals may only share their incomes, revenues, profits or fees with licensed dentists within the same dental practice. Also, only individuals licensed to practice dentistry may direct the hiring, clinical training, supervision and termination of a dentist, dental hygienist or dental assistant. However, a dental practice may have an unlicensed person or firm perform certain administrative activities, such as owning or leasing real property or equipment used by the dental practice.

Assisted Living

Any individual or agency referring a person to an assisted living program will have to be licensed by the Maryland Department of Health’s Office of Health Care Quality (OHCQ), starting on October 1, 2020. These licensed “assisted living referrers” must disclose to clients or potential clients all of their financial relationships with assisted living programs, affirm that those programs are licensed, and notify OHCQ immediately if they learn that a program is operating without a license. Referrers may not make referrals solely to an assisted living program from which they receive compensation.

Board of Physicians

Good moral character is now a requirement for license renewal for all medical license types. Additionally, a supervising physician and physician assistant must notify the Maryland Board of Physicians within 10 days of the termination of a delegation agreement.

Telehealth

Health care practitioners may now establish a practitioner-patient relationship by a real-time telehealth interaction or by an asynchronous interaction, where patients or physicians securely collect and transmit medical data to practitioners. Telehealth still does not include audio-only calls, e-mails or faxed information. To establish a relationship through any form of telehealth, the practitioner must: verify the identity of the patient; disclose to the patient the practitioner’s name, contact information and type of health occupation license; and obtain oral or written consent from the patient to establish the relationship via telehealth.

Hospitals

Starting in July 2021, a hospital that charges an outpatient facility fee must provide a patient with a written notice about the expected fee amount. The hospital may not attempt to bill or collect an outpatient facility fee unless the patient was given the notice. An outpatient facility fee does not include a charge billed for services delivered in an emergency department or a physician fee billed for professional services provided at the hospital.

On October 1, 2020, the minimum requirements for a hospital’s financial assistance policy must be increased to include free medically necessary care to patients with a family income at or below 200% of the federal poverty level (FPL), an increase from 150%. Additionally, a payment plan must now be available for patients with a family income between 200% and 500% of the FPL. Hospitals must also provide notice of the financial assistance policy to the patient before discharge and in each communication about collection of the hospital bill.

Discrimination by Health Care Providers

Starting October 1, 2020, the Maryland Department of Health (MDH) will have concurrent jurisdiction with the Maryland Commission on Civil Rights over alleged discrimination by a hospital, related institution or person licensed or regulated by MDH, based on a person’s race, color, religion, sex, age, national origin, marital status, sexual orientation, gender identity or disability.

Health Insurance Mandates

The Maryland General Assembly implemented three new mandated benefits, all effective on January 1, 2021. First, carriers will be prohibited from applying a deductible, copayment or coinsurance for prostate cancer preventative screening. Second, carriers will be required to provide coverage for a medically necessary diagnosis, evaluation and treatment of pediatric autoimmune neuropsychiatric disorders. And, finally, to qualify for in vitro fertilization, the required involuntary infertility time for married patients will be reduced from two years to at least one year, and the number of required attempts of artificial insemination for same sex couples will be reduced from six attempts during the course of two years to three attempts during the course of one year.

Specialty Drugs

Effective immediately, the definition of specialty drugs now excludes drugs prescribed to treat diabetes, HIV or AIDS. Carriers are prohibited from imposing copayment or coinsurance requirements that exceed $150 for up to a 30-day supply of drugs prescribed to treat diabetes, HIV or AIDS. This price cap will be adjusted annually for inflation.

Medical Cannabis

Physician assistants may certify that a patient qualifies for medical cannabis in Maryland, beginning October 1, 2020. The physician assistant must have an active delegation agreement with a primary supervising physician who is also a certifying provider, and have a state controlled dangerous substances registration.

Barry F. Rosen
410-576-4224 • brosen@gfrlaw.com

A version of this article titled “A look at new Maryland health care laws” was published online by The Daily Record on June 26, 2020.