MD SB474

Adverse decision and grievance notices must now display prominent bold print at the top stating the denial, appeal rights, and dedicated contact information, replacing individual names with unique identifiers for decision-makers

Private review agents must post utilization review criteria on both member and provider website pages, maintain dedicated phone numbers and monitored email addresses for utilization review, and respond to voicemails/emails within 2 business days

Carriers must report adverse decision data to the Maryland Insurance Commissioner aggregated by zip code, and must explain any service categories where denials increased by 10% or more in one year or 25% or more over three years

The Insurance Commissioner gains authority to use adverse decision information as the basis for conducting examinations of carriers

The law takes effect June 1, 2025, with provisions requiring enhanced notice formatting taking effect October 1, 2025