MD HB848

Adverse decision and grievance decision notices must display at the top in prominent bold print that the notice is a denial, the member's right to appeal, a dedicated phone number and email for utilization review, and information about filing assistance

Private review agents must post utilization review criteria on both member and provider pages of their websites, maintain a dedicated telephone number and monitored email address for utilization review, and respond to voicemails or emails within 2 business days

Carriers must submit quarterly reports to the Insurance Commissioner with adverse decision data aggregated by zip code, and must explain any service type where adverse decisions grew by 10% or more in the preceding year or 25% or more over three years

Decision notices must include a unique identifier (rather than name) for the medical director or employee who made the adverse or grievance decision, along with their business address and a dedicated telephone number separate from general customer service

The Insurance Commissioner may use adverse decision data as the basis for examinations of carriers; the act takes effect June 1, 2025, with certain provisions effective October 1, 2025