HB 1445

HOUSE BILL 1445
     J1  6lr2253
  CF SB 742
     By: Delegates Wolek, Bagnall, Barnes, Cullison, Foley, Forbes, Fraser–Hidalgo,
  Guyton, Kaufman, Solomon, Spiegel, Stinnett, Vogel, Wims, Woorman, and
  Young Young, Guzzone, Hill, Hutchinson, S. Johnson, Kipke, Lopez,
  Martinez, Rosenberg, Taveras, and White Holland White Holland, and
  Roberts
     Introduced and read first time: February 13, 2026
     Assigned to: Health
     Committee Report: Favorable with amendments
     House action: Adopted with floor amendments
     Read second time: March 23, 2026
  CHAPTER ______
1 AN ACT concerning
2Maryland Medical Assistance Program and Developmental Disabilities
3Administration – Home– and Community–Based Services Eligibility
4Determinations
5(Maryland Protecting People With Disabilities Act)
6 FOR the purpose of altering the time within which an individual receiving services from
7      the Developmental Disabilities Administration must appeal a loss of eligibility for
8      services; establishing requirements related to eligibility determinations and
9      redeterminations under the Maryland Medical Assistance Program; requiring the
10      Maryland Department of Health to provide certain accessible information to
11      Program recipients and any other individuals on request; prohibiting the
12      Department from procedurally disenrolling individuals from the Program or
13      home– and community–based services solely on a certain basis except under certain
14      circumstances; requiring the Department, subject to federal approval, to reserve
15      certain home– and community–based services waiver slots for Program recipients
16      who lost eligibility under certain circumstances; and generally relating to
17      determinations of eligibility for home– and community–based services.
18 BY repealing and reenacting, with amendments,
19Article – Health – General
20Section 7–309(b)
     EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
  [Brackets] indicate matter deleted from existing law.
  Underlining indicates amendments to bill.
  Strike out indicates matter stricken from the bill by amendment or deleted from the law by
  amendment.
  *hb1445*
2HOUSE BILL 1445
1Annotated Code of Maryland
2(2023 Replacement Volume and 2025 Supplement)
3 BY repealing and reenacting, without amendments,
4Article – Health – General
5Section 15–101(a), (h), and (i)
6Annotated Code of Maryland
7(2023 Replacement Volume and 2025 Supplement)
8 BY adding to
9      Article – Health – General
10      Section 15–103.9
11      Annotated Code of Maryland
12      (2023 Replacement Volume and 2025 Supplement)
13Preamble
14WHEREAS, The landmark decision of the U.S. Supreme Court in Olmstead v. L.C.
15 ex rel. Zimring, 527 U.S. 581 (1999) affirmed that unjustified segregation of individuals
16 with disabilities constitutes discrimination in violation of Title II of the federal Americans
17 with Disabilities Act; and
18WHEREAS, The Olmstead decision established that people with disabilities have
19 the right to receive services in the most integrated setting appropriate to their needs and
20 that states must provide community–based services when such services are appropriate,
21 desired by the individual, and can be reasonably accommodated; and
22WHEREAS, Individuals with intellectual and developmental disabilities are vital
23 members of Maryland’s communities, contributing meaningfully in workplaces, classrooms,
24 places of worship, neighborhoods, and civic life across the State; and
25WHEREAS, The State of Maryland has demonstrated a longstanding commitment
26 to community inclusion by closing nearly all large public institutions for people with
27 intellectual and developmental disabilities and investing in supports that allow
28 Marylanders with disabilities to live, work, and thrive in the communities of their choosing,
29 with people they choose; and
30WHEREAS, Despite this progress, barriers remain when administrative
31 inefficiencies and delays in Medicaid eligibility determinations or redeterminations cause
32 individuals to lose critical home– and community–based services or remain
33 institutionalized after they are medically ready for discharge; and
34WHEREAS, Ensuring timely Medicaid eligibility determinations, preventing
35 procedural terminations, and protecting continuity of home– and community–based
36 services coverage are necessary to fulfill the promise of Olmstead and uphold Maryland’s
37 commitment to dignity, inclusion, and equality for all people with disabilities; and
  HOUSE BILL 1445  3
1WHEREAS, Maryland law requires the Developmental Disabilities Administration
2 and the Department of Disabilities to compile statewide and regional data from written
3 plans of habilitation, including barriers to community placement, and to incorporate the
4 data annually into the State’s Olmstead Plan together with recommendations for
5 addressing those barriers; now, therefore,
6SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
7 That the Laws of Maryland read as follows:
8Article – Health – General
9 7–309.
10(b)  (1)     An individual receiving Administration services who receives notice
11 from the Department that the individual has lost eligibility to receive Maryland Medical
12 Assistance Program services [shall have 90 days after the date on which the notification
13 letter was mailed to] MAY appeal the determination.
14(2)   If an individual appeals a loss of eligibility within the time period
15 required under [paragraph (1) of this subsection] § 42 C.F.R. 431.231, Administration
16 services for the individual shall continue uninterrupted until the outcome of the appeal is
17 complete.
18(3)   The Department shall ensure that providers of Administration services
19 to an individual affected by a loss of eligibility are notified of the individual’s loss of
20 eligibility when notice is sent to the individual.
21(4)  The Department shall ensure that providers, including coordinators of
22 community services, have the ability to automatically exchange electronic data with the
23 Department through an application program interface with the Department’s Long Term
24 Services and Supports software system.
25 15–101.
26(a)    In this title the following words have the meanings indicated.
27(h)    “Program” means the Maryland Medical Assistance Program.
28(i)    “Program recipient” means an individual who receives benefits under the
29 Program.
30 15–103.9.
31(A)    (1)   IN THIS SECTION THE FOLLOWING WORDS HAVE THE MEANINGS
32 INDICATED.
4HOUSE BILL 1445
1(2) “EX PARTE REDETERMINATION” MEANS A PROCESS BY WHICH
2 THE DEPARTMENT DETERMINES A PROGRAM RECIPIENT’S ELIGIBILITY TO
3 CONTINUE TO RECEIVE SERVICES USING EXISTING DATA, WITHOUT REQUIRING THE
4 PROGRAM RECIPIENT TO SUBMIT ADDITIONAL INFORMATION.
5(3)     “HOME– AND COMMUNITY–BASED SERVICES” MEANS SERVICES
6 AUTHORIZED UNDER A MEDICAID STATE PLAN OPTION OR WAIVER UNDER § 1115
7 OR § 1915(C), (I), OR (K) OF THE FEDERAL SOCIAL SECURITY ACT.
8(4)
  “PROCEDURAL DISENROLLMENT” MEANS THE TERMINATION OF A
9 PROGRAM RECIPIENT’S ELIGIBILITY TO RECEIVE SERVICES BASED ON REASONS
10 RELATED TO THE RENEWAL PROCESS AND NOT ON A DETERMINATION OF
11 INELIGIBILITY.
12      (B) THE DEPARTMENT SHALL COMPLY WITH THE REQUIREMENTS OF 42
13 C.F.R. § 435.912 RELATED TO THE TIMELY DETERMINATION AND
14 REDETERMINATION OF PROGRAM ELIGIBILITY, INCLUDING PROCESSING AN
15 APPLICATION:
16(1)  IF A DETERMINATION OF DISABILITY IS NOT REQUIRED, WITHIN
17 45 DAYS AFTER THE RECEIPT OF THE APPLICATION; AND
18(2) IF A DETERMINATION OF DISABILITY IS REQUIRED, WITHIN 90
19 DAYS AFTER THE RECEIPT OF THE APPLICATION.
20      (C)  THE DEPARTMENT SHALL CONDUCT EX PARTE REDETERMINATIONS
21 AND USE ALL PROCEDURES AUTHORIZED UNDER 42 C.F.R. § 435.916 TO PREVENT
22 PROCEDURAL DISENROLLMENT OF INDIVIDUALS RECEIVING HOME– AND
23 COMMUNITY–BASED SERVICES.
24      (D)  IN ACCORDANCE WITH 42 C.F.R. § 435.905 AND SUBJECT TO
25 SUBSECTION (E) OF THIS SECTION, THE DEPARTMENT SHALL PROVIDE, IN
26 ELECTRONIC AND PAPER FORMATS, AND ORALLY AS APPROPRIATE AN
27 ACCOMMODATION, THE FOLLOWING INFORMATION TO ALL APPLICANTS AND OTHER
28 INDIVIDUALS ON REQUEST:
29(1)   REQUIREMENTS FOR PROGRAM ELIGIBILITY;
30(2)   AVAILABLE PROGRAM SERVICES; AND
31(3)THE RIGHTS AND RESPONSIBILITIES OF APPLICANTS AND
32 PROGRAM RECIPIENTS.
  HOUSE BILL 1445  5
1      (E)   (1)   THE DEPARTMENT SHALL PROVIDE THE INFORMATION
2 REQUIRED UNDER SUBSECTION (D) OF THIS SECTION IN PLAIN LANGUAGE AND IN A
3 MANNER THAT IS TIMELY AND ACCESSIBLE TO INDIVIDUALS WHO ARE:
4(I) LIMITED ENGLISH PROFICIENT THROUGH THE PROVISION
5 OF LANGUAGE SERVICES, INCLUDING ORAL INTERPRETATION AND WRITTEN
6 TRANSLATIONS, AT NO COST TO THE INDIVIDUAL; OR
7(II)   LIVING WITH DISABILITIES THROUGH THE PROVISION OF
8 AUXILIARY AIDS AND SERVICES AT NO COST TO THE INDIVIDUAL IN ACCORDANCE
9 WITH THE FEDERAL AMERICANS WITH DISABILITIES ACT AND § 504 OF THE
10 FEDERAL REHABILITATION ACT OF 1973.
11(2) THE DEPARTMENT SHALL PROVIDE TAGLINES IN NON–ENGLISH
12 LANGUAGES TO INFORM INDIVIDUALS OF:
13(I)  THE AVAILABILITY OF THE ACCESSIBLE INFORMATION AND
14 LANGUAGE SERVICES UNDER THIS SECTION; AND
15(II)   HOW TO ACCESS THE INFORMATION AND SERVICES.
16      (F)   IFTHE DEPARTMENT DETERMINES THAT THE INFORMATION
17 NECESSARY TO CONFIRM A PROGRAM RECIPIENT’S ELIGIBILITY TO CONTINUE TO
18 RECEIVE SERVICES IS INCOMPLETE, THE DEPARTMENT SHALL CONTINUE TO
19 PROVIDE THE HOME– AND COMMUNITY–BASED SERVICES AND OTHER SERVICES
20 UNDER THE PROGRAM UNTIL THE PROGRAM RECIPIENT HAS EXHAUSTED ALL DUE
21 PROCESS RIGHTS AND A FINAL DETERMINATION IS ISSUED.
22      (G)   (1) IF A PROGRAM RECIPIENT IS PROCEDURALLY DISENROLLED
23 FROM HOME– AND COMMUNITY–BASED SERVICES DUE TO A FAILURE BY THE
24 DEPARTMENT TO REDETERMINE ELIGIBILITY IN A TIMELY MANNER AND THE DELAY
25 IN THE REDETERMINATION WAS NO FAULT OF THE PROGRAM RECIPIENT AFTER THE
26 RECIPIENT HAS TIMELY RETURNED INFORMATION REQUIRED UNDER 42 C.F.R §
27 435.916(B)(2)(1)(B) AND 42 C.F.R § 435.952(C), THE DEPARTMENT SHALL
28 REINSTATE THE PROGRAM RECIPIENT’S ELIGIBILITY AND THE PROVISION OF
29 HOME– AND COMMUNITY–BASED SERVICES AND AUTHORIZE ENROLLMENT
30 RETROACTIVELY TO THE DATE OF DISENROLLMENT PENDING THE DEPARTMENT’S
31 COMPLETION OF THE REDETERMINATION PROCESS.
32(2) THIS SUBSECTION MAY NOT BE CONSTRUED TO LIMIT THE
33 DEPARTMENT’S AUTHORITY OR DIMINISH THE DEPARTMENT’S RESPONSIBILITY TO
34 REINSTATE THE ELIGIBILITY OF AND THE PROVISION OF HOME– AND
35 COMMUNITY–BASED SERVICES TO A PROGRAM RECIPIENT WHO HAS BEEN
6HOUSE BILL 1445
1 DISENROLLED FOR A REASON OTHER THAN A FAILURE BY THE DEPARTMENT TO
2 REDETERMINE ELIGIBILITY IN A TIMELY MANNER.
3      (H) (G)  SUBJECT TO FEDERAL APPROVAL, THE DEPARTMENT SHALL
4 RESERVE A PORTION OF THE PARTICIPANT CAPACITY IN THE HOME– AND
5 COMMUNITY–BASED SERVICES WAIVER UNDER § 1915(C) OF THE FEDERAL SOCIAL
6 SECURITY ACT WAIVERS FOR SERVICES NEEDED BY PROGRAM RECIPIENTS WITH
7 DEVELOPMENTAL DISABILITIES WHO:
8(1)
  WERE DISENROLLED FROM THE MARYLAND MEDICAID HOME
9 AND COMMUNITY–BASED SERVICES WAIVER PROGRAM ON OR AFTER JANUARY 1,
10 2024;
11(2)   HAVE HAD PROGRAM ELIGIBILITY REINSTATED; AND
12(3)   HAVE REQUESTED THE REINSTATEMENT OF WAIVER SERVICES.
13      (I)   THE DEPARTMENT MAY NOT PLACE AN INDIVIDUAL ON A WAITING LIST
14 OR REQUIRE A NEW WAIVER APPLICATION IF THE DISENROLLMENT OF THE
15 INDIVIDUAL RESULTED FROM A DELAY OR AN ERROR BY THE DEPARTMENT.
16      (J) (H)     (1)THE DEPARTMENT MAY NOT PROCEDURALLY DISENROLL
17 AN INDIVIDUAL FROM THE PROGRAM OR HOME– AND COMMUNITY–BASED SERVICES
18 SOLELY BASED ON MISSING DOCUMENTATION, A MISSING SIGNATURE, OR
19 INCOMPLETE INFORMATION UNLESS THE DEPARTMENT HAS:
20(I)   EXHAUSTED ALL EX PARTE VERIFICATION PROCESSES
21 REQUIRED UNDER 42 C.F.R. § 435.916;
22(II)PROVIDED A CLEAR, SPECIFIC, AND ACCESSIBLE WRITTEN
23 NOTICE IDENTIFYING THE EXACT INFORMATION REQUIRED; AND
24(III) PROVIDED THE PROGRAM RECIPIENT WITH A REASONABLE
25 OPPORTUNITY TO SUPPLY THE INFORMATION; AND
26(IV) VERIFIED THAT THE INDIVIDUAL RECEIVED THE NOTICE
27 REQUIRED UNDER ITEM (II) OF THIS PARAGRAPH AND DOCUMENTED THE
28 VERIFICATION.
29(2) IF THE DEPARTMENT VIOLATES PARAGRAPH (1) OF THIS
30 SUBSECTION, A PROGRAM RECIPIENT’S HOME– AND COMMUNITY–BASED SERVICES
31 SHALL CONTINUE WITHOUT INTERRUPTION.
  HOUSE BILL 1445  7
1(K) (I)  IF THE DEPARTMENT DISENROLLS A PROGRAM RECIPIENT IN
2 VIOLATION OF THIS SECTION, THE DEPARTMENT SHALL:
3(1) AUTOMATICALLY REINSTATE PROGRAM AND HOME– AND
4 COMMUNITY–BASED SERVICES RETROACTIVE TO THE DATE OF DISENROLLMENT;
5 AND
6(2)   TREAT THE PROGRAM RECIPIENT AS CONTINUOUSLY ENROLLED.
7SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read
8 as follows:
9Article – Health – General
10 15–103.9.
11(L) (J) (1) ON OR BEFORE JANUARY 1, 2027, AND QUARTERLY
12 THEREAFTER, THE DEPARTMENT SHALL:
13(I)
  SUBMIT TO THE GENERAL ASSEMBLY, IN ACCORDANCE
14 WITH § 2–1257 OF THE STATE GOVERNMENT ARTICLE, A REPORT REGARDING
15 PROGRAM RECIPIENTS WHO RECEIVE HOME– AND COMMUNITY–BASED SERVICES;
16 AND
17(II) POST EACH REPORT SUBMITTED UNDER ITEM (I) OF THIS
18 PARAGRAPH ON THE DEPARTMENT’S WEBSITE.
19(2)THE REPORTS REQUIRED UNDER PARAGRAPH (1) OF THIS
20 SUBSECTION SHALL INCLUDE:
21(I)
  THE TOTAL NUMBER OF PROGRAM RECIPIENTS FOR WHOM
22 A REDETERMINATION OF ELIGIBILITY WAS INITIATED;
23(II)
  THE TOTAL NUMBER OF PROGRAM RECIPIENTS FOR WHOM
24 PROGRAM COVERAGE IS RENEWED;
25(III) OF THE PROGRAM RECIPIENTS WHOSE ELIGIBILITY IS
26 RENEWED, THE TOTAL NUMBER WHOSE COVERAGE WAS RENEWED BASED ON AN EX
27 PARTE REDETERMINATION;
28(IV)
  THE TOTAL NUMBER OF PROGRAM RECIPIENTS WHOSE
29 ELIGIBILITY WAS REINSTATED IN ACCORDANCE WITH SUBSECTION (F) OF THIS
30 SECTION;
8HOUSE BILL 1445
1(IV) (V)
  THE TOTAL NUMBER OF PROGRAM RECIPIENTS
2 WHOSE ELIGIBILITY WAS TERMINATED;
3(V) (VI)
  THE TOTAL NUMBER OF PROGRAM RECIPIENTS
4 WHOSE ELIGIBILITY WAS TERMINATED FOR PROCEDURAL REASONS;
5(VII) THE TOTAL NUMBER OF PROGRAM RECIPIENTS WHOSE
6 ELIGIBILITY WAS TERMINATED DUE TO A FAILURE BY THE DEPARTMENT TO
7 REDETERMINE ELIGIBILITY IN A TIMELY MANNER; AND
8(VI) (VIII)
  THE MEAN AND MEDIAN PROCESSING TIMES FOR
9 REDETERMINATIONS OF ELIGIBILITY.
10SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
11 October 1, 2026. Section 2 of this Act shall remain effective for a period of 3 years and, at
12 the end of September 30, 2029, Section 2 of this Act, with no further action required by the
13 General Assembly, shall be abrogated and of no further force and effect.
     Approved:
     ________________________________________________________________________________
  Governor.
     ________________________________________________________________________________
  Speaker of the House of Delegates.
     ________________________________________________________________________________
  President of the Senate.