SB0834/Ch. 298, HB 1148/Ch. 297(2), 2022 - Health Insurance – Two–Sided Incentive Arrangements and Capitated Payments – Authorization requires the Maryland Health Care Commission (MHCC) to aggregate the (1) the number and type of value–based arrangements entered into in accordance with the authority established under the law; (2) quality outcomes of the value–based arrangements; (3) the number of complaints made regarding value–based arrangements; (4) the cost–effectiveness of the value–based arrangements; and (5) the impact of two–sided incentive arrangements on the fee schedules of health care practitioners included in the target budget that are not eligible providers.

In addition to meeting these requirements, MHCC is interested in seeking provider feedback on value-based arrangements in the commercial fully-insured market.  

Provider Feedback

Provider feedback should be shared via email or this form. Providers submitting feedback should submit their answers in numbered response to the questions. Please see attached

Submission Guidance

Please submit your responses by email or using this form. All submissions should be directed to Shankar Mesta at Shankar.Mesta@maryland.gov. Please ensure your submission is completed by September 23rd, 2025.

If you have any questions or need assistance with the submission process, feel free to reach out to Shankar Mesta at Shankar.Mesta@maryland.gov.

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, 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 re-proposed at this time.  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 healthcare 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.

The Maryland Health Care Commission (MHCC) is seeking public comment on an application for access to data from the Maryland Medical Care Database (MCDB). As required by COMAR 10.25.05.07, the MHCC accepts public comments on completed applications for a period of 10 business days following publication.

The applications under review are:

1. Lorraine Dean, Johns Hopkins Bloomberg School of Public Health. Project Title: "Assessing the Health Impacts of Guaranteed Income in Maryland"

All comments received will be provided to the Data Release Advisory Committee for consideration during the application review process, as outlined in COMAR 10.25.05.09.

Comments may be submitted via email to mahlet.konjit-solomon@maryland.gov.  Please reference the applicant name and project title in your comments.