Mid-Atlantic Health Law TOPICS

The Maryland General Assembly’s 2025 legislative Session concluded with the enactment of many health care laws that will impact health care facilities, providers, insurers, and patients in the State. Here are some of the highlights from the 2025 Session.

Artificial Intelligence 

A new law was enacted concerning the use of Artificial Intelligence (AI) by certain carriers, including insurers, in decision making, either directly or through contracted entities. The AI must comply with certain criteria and guidelines and cannot replace the role of health care providers. The law mandates fair and equitable application of AI, prohibiting unfair discrimination against enrollees. Carriers are required to review and revise AI performance quarterly, ensure patient data is used only for its intended purpose, and must make AI systems open to inspection by the Insurance Commissioner. Importantly, the bill explicitly states that AI, algorithms, or other software tools may not deny, delay, or modify health care services, and the quarterly reports must include whether an AI was used in making an adverse decision.

Adverse Decisions 

Carriers will be required to include specific information in adverse and grievance decision notices, such as prominently displaying that the notice is a denial of service and providing instructions for appeals or complaints. The new law also mandates the inclusion of a unique identifier, business address, and telephone number for the decision-maker, as well as detailed explanations of the decision rationale.

A workgroup was also established to review existing adverse decision reporting requirements, analyze data on adverse decisions, and make recommendations for improving reporting. This includes developing standardized definitions and methods for categorizing and reporting adverse decisions. The group must also develop strategies to reduce adverse decisions and recommend legislation to address the issue.

Maryland’s Paid Family and Medical Leave Insurance (FAMLI) Program 

Maryland’s Family and Medical Leave Insurance Program (FAMLI) was established through the Time to Care Act of 2022. Newly enacted legislation alters several dates related to the FAMLI program’s implementation and reporting requirements. It pushes back the start date for contributions to January 1, 2027, and adjusts the annual reporting deadline to October 1 of each year. The new provisions require the Maryland Department of Labor to adopt regulations establishing an optional self-employed enrollment program by July 1, 2028, which replaces previous requirements for self-employed individuals’ participation and contribution payments. The act maintains the maximum total contribution rate at 1.2% of an employee’s wages up to the Social Security wage base but modifies how the covered employee’s average weekly wage is calculated.

Telehealth 

The Preserve Telehealth Access Act of 2025 aims to extend and expand telehealth services in Maryland by removing limitations set to expire in 2025. Key changes include repealing the expiration date for audio-only telehealth, removing time limits on reimbursement parity for telehealth services, and allowing more flexibility in prescribing controlled substances via telehealth. The bill mandates the Maryland Health Care Commission to report on telehealth advances or developments every four years starting in 2026. It maintains insurance coverage for telehealth services, including behavioral health, and prohibits lifetime dollar maximums.

ICE Protection 

A new Maryland law requires federal enforcement officers, including ICE officers, to notify local authorities about any investigation, enforcement action, or federal immigration enforcement action at a sensitive location. Sensitive locations include “any location that provides state-funded services related to physical or mental health.” The law does not prohibit 287(g) agreements, meaning local authorities may still assist federal officers who carry out enforcement actions. The law also requires the Maryland Attorney General to develop guidance for immigration enforcement in sensitive locations. The bill also prevents the sale of personal records and other data by government entities to third parties.

Building Energy Performance Standards 

Hospitals outside of Montgomery County are now exempt from the requirements of Maryland’s Building Energy Performance Standards, albeit that the definition of what constitutes a “hospital” is still being finalized. Previously, a hospital would have been required to submit a benchmarking report to the Maryland Department of the Environment by September 1, 2025, and meet certain efficiency and greenhouse gas emissions standards by 2030. Montgomery County hospitals will now be governed solely by Montgomery County’s Building 
Energy Performance Standards program.
 

K. Eva Kessler
410-576-4251 • kkesler@gfrlaw.com

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