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HB 1445

Maryland Medical Assistance Program and Developmental Disabilities Administration - Home- and Community-Based Services Eligibility Determinations (Maryland Protecting People With Disabilities Act)

2026 Regular Session Introduced by Heather Bagnall Tudball and 25 co-sponsors

HB 1445 strengthens timely, uninterrupted HCBS/Medicaid eligibility, protects against procedural disenrollment, and ensures accessible information and continuity of services.

Second Reading Passed
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Bill Summary · HB 1445

Summary of Maryland House Bill 1445 (2026) – Maryland Protecting People With Disabilities Act

Jurisdiction: Maryland | Session: 2026 | Committee: Health

Purpose and Intent

HB 1445 aims to enhance the administration of home- and community-based services (HCBS) under the Maryland Medical Assistance Program (Medicaid) and the Developmental Disabilities Administration (DDA). The bill is grounded in Olmstead principles, seeking to reduce barriers, prevent unwarranted disenrollments, ensure timely eligibility determinations and redeterminations, improve accessibility of information, and preserve waiver capacity for individuals who lose eligibility under certain circumstances. It codifies federal requirements and aligns state practice with nationwide standards for Medicaid eligibility processing and HCBS continuity.

Key policy goals include:
- Timely and accurate eligibility determinations and redeterminations for Medicaid and HCBS.
- Protection against procedural disenrollment from Medicaid and HCBS.
- Accessible, plain-language information and language-access services for applicants and recipients.
- Retroactive reinstatement and continuous enrollment when procedural issues cause disenrollment.
- Reserve waiver capacity for certain recipients who were disenrolled and subsequently reinstated.

Main Provisions and Changes

  1. Appeals Window for Loss of Eligibility (DDA Services)

    • Removes a fixed 90-day appeal window and allows an individual to appeal a loss of eligibility.
    • If an appeal is filed within the federal-required period (per 42 C.F.R. 431.23), HCBS can continue uninterrupted during the appeal process.

  2. Notification and Data Exchange

    • The Department must notify HCBS providers when an individual loses eligibility.
    • Requires automatic data exchange capabilities between HCBS providers/coordinators and the Department’s Long Term Services and Supports (LTSS) system via an API.

  3. Ex Parte Redeterminations and Timeliness (Federal Compliance)

    • The Department must comply with 42 C.F.R. § 435.912:
      • Determine disability/non-disability: within 45 days (disability not required) or 90 days (disability required) after receipt of an application.
    • Ex parte redeterminations should be conducted to prevent procedural disenrollments.

  4. Information for Applicants and Recipients

    • Mandates that the Department provide information on eligibility requirements, available services, and recipient rights/responsibilities.
    • Information must be in plain language and accessible (including for Limited English Proficiency and individuals with disabilities), with language services and auxiliary aids at no cost.
    • Taglines in non-English languages must inform about accessibility and how to access services.

  5. Continued Services During Incomplete Data (Provision of HCBS)

    • If information needed to confirm eligibility is incomplete, HCBS and other program services must continue until due process rights are exhausted and a final determination is issued.

  6. Procedural Disenrollment Protections and Reinstatement

    • If procedural disenrollment occurs due to the Department’s failure to redetermine timely, and the delay was not the recipient’s fault, the Department must reinstate eligibility and retroactively enroll the recipient to the date of disenrollment.
    • This does not limit the Department’s authority in other cases.

  7. Waiver Capacity Reservation (Subject to Federal Approval)

    • Reserve a portion of HCBS waiver slots for Program recipients with developmental disabilities who were disenrolled after Jan 1, 2024, had eligibility reinstated, and requested reinstatement of waiver services.
    • Prohibits waiting list placement or new waiver applications for these individuals if their disenrollment resulted from a Department delay or error.

  8. Prohibition on Procedural Disenrollment for Missing Documentation (Strict Process)

    • The Department may not procedurally disenroll based solely on missing documentation/signature/ incomplete information unless:
      • Exhaust ex parte verification processes,
      • Provide clear, specific, and accessible written notice identifying required information,
      • Provide reasonable opportunity to supply information,
      • Verify that the notice was received.
    • If violated, HCBS must continue uninterrupted.

  9. Automatic Reinstatement and Continuity if Violated

    • If a procedural disenrollment occurs in violation of these requirements, the Department must automatically reinstate and treat the recipient as continuously enrolled.

  10. Reporting Requirements (Starting 2027)

    • On or before Jan 1, 2027, and quarterly thereafter, the Department must report to the General Assembly and post on the website:
      • Total individuals for whom redetermination was initiated.
      • Total recipients whose coverage was renewed, including those renewed via ex parte redetermination.
      • Total reenrollments following procedural disenrollment due to Department delay.
      • Total terminations (including those for procedural reasons and those due to delays).
      • Mean and median processing times for redeterminations.
    • Reports cover HCBS recipients and will be published on the Department’s website.
    • The reporting requirement is set to run through Sept 30, 2029.

Affected Parties

  • Primary: Maryland residents who receive Medicaid HCBS and/or DDA services.
  • State Agencies: Maryland Department of Health (MDH) and the Developmental Disabilities Administration (DDA).
  • Service Providers: HCBS providers and coordinators who must interface with MDH systems.
  • Waiver Participants: Recipients of the HCBS waivers, particularly those with developmental disabilities who experienced disenrollment issues.

Timeline and Effective Date

  • Effective date: October 1, 2026.
  • Ongoing requirements beginning with 2027 reporting, continuing through September 30, 2029.
  • Provisions align with federal standards and would require federal approval for certain waiver capacity reservations.

Fiscal and Administrative Considerations

  • MDH notes that the bill largely codifies existing federal requirements; any additional workload is expected to be manageable within current resources.
  • No anticipated change in state revenues; no local or small-business fiscal impacts identified.
  • The bill includes a sunset-like reporting window ending September 30, 2029, after which the legislature may review continuing requirements.

Notes

  • The bill references a parallel Senate bill (SB 742) and aligns with Olmstead obligations to provide community-based services when appropriate.
  • This summary reflects the text as introduced and amended in the 2026 session.

Compiled from official sources — confirm details with the bill’s official record.

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