The Maryland Department of Health is proposing a new set of regulations for the behavioral health system that it says will reduce fraud and waste.
The proposals are part of a three-phase approach to better oversee the system, which has seen rapid growth in the state in recent years.
“This action marks a significant step in combating fraud and ensuring quality health care for all Marylanders,” said Maryland Health Secretary Dr. Meena Seshamani. “As a regulator and state behavioral health authority, we take our responsibility to provide behavioral health care seriously. Maryland individuals and families deserve high-quality health care services they can trust.”
The regulations create staffing requirements for some facilities, establish new procedures for licensing and strengthen disciplinary measures MDH can use when organizations fail to meet requirements.
They include:
- Chapter 1: Compliance and Reporting Requirements (10.63.01): This chapter proposes clear standards to reduce misinterpretation and enhance the Department's ability to ensure consistent provider accountability.
- Chapter 2: Staffing Requirements (10.63.02): This chapter establishes the staffing requirements for all community-based behavioral health organizations licensed under this subtitle. By establishing these necessary staffing patterns, the Department aims to improve its oversight of service delivery and ensure that organizations have the appropriate personnel to provide services effectively.
- Chapter 6: Application and Licensure Process (10.63.06): This chapter provides clear application requirements and licensing procedures for community-based behavioral health organizations. In doing so, the Department aims to streamline submission, review, and decision-making, and enhance the ability to ensure that all licensed organizations fully comply with relevant regulations.
- Chapter 9: Corrective Actions and Sanctions for Non-Compliance (10.63.09): This chapter strengthens the potential actions the Department might take when provider organizations fail to meet the regulatory requirements, as well as creating more transparency with provider organizations regarding the disciplinary measures that may be implemented for non-compliance.
MDH implemented a set of regulations in April to “create for the first time civil money penalties for community-based behavioral health organizations with material and egregious violations of state or federal laws or regulations,” according to the agency.
As the department worked on the regulations and proposals, it placed a year-long moratorium on new provider enrollments in Medicaid for some mental health and addiction facilities.
MDH plans to propose a final set of regulations this summer focused on licensing programs.
Gene Ransom, the president of the Maryland State Medical Society, said the organization supports reducing fraud but that MDH should keep other concerns in mind.
“I think the concern is we just need to do it and a slow, measured way to make sure that we don't put additional burdens on behavioral health practitioners that creates an access to care issue when we already have one,” Ransome said.
The current proposals garnered more than 900 comments from local behavioral health nonprofits and providers.
