Request for Public Comment

10.25.07 Certification of Electronic Health Networks and Medical Care Electronic Claims Clearinghouses - Comments due September 8, 2025

Notice of Proposed Action [24-165-R] Volume 52 Issue 15 Maryland Register August 8, 2025

The Maryland Health Care Commission proposes to amend Regulations .01, .02 and .05, adopt new Regulation .09, amend and recodify existing Regulations .09 and .10 to be Regulations .10 and .11, and recodify existing Regulation .11 to be Regulation .12 under COMAR 10.25.07 Certification of Electronic Health Networks and Medical Care Electronic Claims Clearinghouses.  This action was considered by the Commission at an open meeting held on June 12, 2025, a notice of which was given through publication in the Maryland Register, in accordance with General Provisions Article, §3-302(c), Annotated Code of Maryland. Because substantive changes have been made to the original proposal as published in 51:24 Md. R. 1086—1088 (December 2, 2024), this action is being reproposed at this time.  

Comments may be sent to Anna Gribble, Assistant Division Chief, Center for Health Information Technology, Maryland Health Care Commission, 4160 Patterson Avenue Baltimore, Maryland 21215, or call 410-764-3379, or email to mhcc_regs.comment@maryland.gov. Comments will be accepted through September 8, 2025. A public hearing has not been scheduled.

Statement of Purpose

The purpose of this action is to re-propose amendments and a new regulation to COMAR 10.25.07 Certification of Electronic Health Networks and Medical Care Electronic Claims Clearinghouses.

Legislation passed by the Maryland General Assembly in 2021 (Chapter 790/House Bill 1022 and Chapter 791/Senate Bill 748, Public Health—State Designated Exchange—Clinical Information) requires the Maryland Health Care Commission (MHCC) to adopt regulations to support a State health improvement program, mitigate a public health emergency, and improve patient safety by requiring MHCC-certified electronic health networks (EHNs) to provide electronic health care transaction information to the State-designated health information exchange (HIE) for clinical and public health purposes. 

Legislation passed by the Maryland General Assembly in 2025 (Chapter 615/House Bill 1104, Maryland Department of Health—AHEAD Model Implementation—Electronic Health Care Transactions and Population Health Improvement Fund) clarifies that electronic health care transaction information may be used to support the State’s participation in the Advancing All-Payer Health Equity Approaches and Development (AHEAD) Model and any successor models, among other things. 

The re-proposed amendments clarify and build upon proposed regulations published in Volume 51, Issue 24 of the Maryland Register on December 2, 2025 based on certain public comments received and new legislation passed during the 2025 Maryland legislative session pertaining to the AHEAD Model.

Re-proposed amendments:

(1) Adds EHNs and the State-designated HIE to the scope of the chapter;

(2) Modifies when EHNs must demonstrate compliance with Health-General Article, §4-302.5, Annotated Code of Maryland;

(3) Allows electronic health care transaction information to be used for public health and clinical purposes to facilitate the State’s participation in the AHEAD Model;

(4) Clarifies required components and processes for the State-designated HIE in developing the Electronic Health Care Transactions Technical Submission Guidance;

(5) Extends the implementation timeline for the State-designated HIE and EHNs; and

(6) Adds requirements for the State-designated HIE and EHNs to report to MHCC on their implementation of the regulations.

Re-proposed amendments build upon previous amendments that:

(1) Add definitions for improvement of patient safety, mitigation of a public health emergency, State-designated HIE, and state health improvement program;

(2) Adds a regulation requiring MHCC-certified EHNs to submit certain electronic health care transactions to the State-designated HIE for public health and clinical purposes;

(3) Requires the State-designated HIE to develop and publish Electronic Health Care Transactions Technical Submission Guidance;

(4) Prohibits EHNs from charging a fee for providing electronic health care transaction information; and

(5) Allows EHNs to request a one-year exemption from certain reporting requirements.