Maryland legislation · 2026 Regular Session
Maryland HB1376: Maryland Medical Assistance Program, Maryland Children's Health Program, and Health Insurance - Transfers to Special Pediatric Hospitals - Requirements
Status: Signed into law, April 28, 2026
Requiring the Maryland Medical Assistance Program and the Maryland Children's Health Program to provide a prior authorization determination regarding a transfer on request of a special pediatric hospital within 3 business days after the request is received; and requiring the Maryland Department of Health to adopt regulations on or before December 31, 2026, establishing a retrospective review process for special pediatric hospitals.
What the bill says
A bill ENTITLED AN ACT concerning Maryland Medical Assistance Program, Maryland Children's Health Program, and Health Insurance - Transfers to Special Pediatric Hospitals - Requirements FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland Children's Health Program, managed care organizations, and certain health insurers, nonprofit health service plans, and health maintenance organizations to provide a prior authorization determination regarding a transfer on request of a special pediatric hospital or referring health care provider, to provide a retrospective revie…
From the introduced text, February 13, 2026:
A BILL ENTITLED AN ACT concerning Maryland Medical Assistance Program, Maryland Children's Health Program, and Health Insurance - Transfers to Special Pediatric Hospitals - Requirements FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland Children's Health Program, managed care organizations, and certain health insurers, nonprofit health service plans, and health maintenance organizations to provide a prior authorization determination regarding a transfer on request of a special pediatric hospital or referring health care provider, to provide a retrospective review of a determination of medical necessity under certain circumstances, and to reimburse a special pediatric hospital or a referring health care provider for administrative days at the applicable rate for a certain period; and generally relating to transfers to special pediatric hospitals. BY repealing and reenacting, without amendments, Article - Health - General Section 15-101(a) and (k), 15-102.3(m), and 15-103(a)(1) and (2)(xxvi) Annotated Code of Maryland (2023 Replacement Volume and 2025 Supplement) BY repealing and reenacting, with amendments, Article - Health - General Section 15-158 Annotated Code of Maryland (2023 Replacement Volume and 2025 Supplement) BY repealing and reenacting, with amendments, Article - Insurance Section 15-861 Annotated Code of Maryland (2017 Replacement Volume and 2025 Supplement) EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW. [Brackets] indicate matter deleted from exist in g l aw . *hb1376* HOUSE BILL 1376 …