MD SB776

Establishes a Workgroup to Study the Rise in Adverse Decisions in the State Health Care System, comprising legislators, state agency officials, and Governor-appointed representatives from hospitals, insurers, managed care plans, physicians, pharmacies, behavioral health providers, and patient advocacy organizations.

Requires the Workgroup to review existing adverse decision reporting requirements across all health payers, analyzing denial rates, enrollee numbers, diagnostic information, and network adequacy data.

Directs the Workgroup to recommend standardized definitions for medical service categories, health settings, adverse decisions, and medical necessity, as well as uniform processes for categorizing denials and filing appeals.

Mandates a report to the Senate Finance Committee and House Health and Government Operations Committee by December 1, 2025, with recommendations for legislation to reduce adverse decisions and standardize reporting across all payers.

Takes effect June 1, 2025, and automatically sunsets on June 30, 2026.