HB 1153

Maryland Medical Assistance Program and Health Insurance - Claims for Reimbursement - Downcoding

Sponsor: Pam Lanman Guzzone (District 13)Committee: HealthSubject: Health - InsuranceStatus: Hearing 3/05 at 1:00 p.m. (as of Sep 4, 2026)

What this bill does

Official synopsis

Prohibiting insurers, nonprofit health service plans, health maintenance organizations, and managed care organization from downcoding a claim for reimbursement under certain circumstances; establishing certain procedures that insurers, nonprofit health service plans, health maintenance organizations, and managed care organizations are required to follow if the insurer, nonprofit health service plan, or health maintenance organization intends or makes a final decision to downcode a claim; etc.

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Testimony (29)

MGA witness list

FAV 18FavorableFWA 5Favorable with amendmentsUNF 6Unfavorable

Position	Witness	Organization	Testimony
FAV	Mansfield, Andrealobbyist	Licensed Clinical Professional Counselors of Maryland	Written (PDF)
FAV	Jarrell, Susan	LifeBridge Health	Oral + Written (PDF)
FAV	Murphy, JD	MD Chesapeake Chapter of the National Association of Pediatric Nurse Practitioners (NAPNAP)	Position only
FAV	Guzzone, Pam	MGA	Written (PDF)
FAV	Whitaker, Jakelobbyist	Maryland Hospital Association	Oral + Written (PDF)
FAV	Plante, Cecilia	Maryland Legislative Coalition	Position only
FAV	Doring, Charles	Maryland State Dental Association	Oral
FAV	Maury, Erinn	MedChi	Written (PDF)
FAV	Rubenstein, Jonathan	MedChi	Oral + Written (PDF)
FAV	Thomas, Amy	MedChi	Oral + Written (PDF)
FAV	Paddy, Michaellobbyist	Public Policy Partners	Oral + Written (PDF)
FAV	Tilburg, Will	University of Maryland Medical System	Written (PDF)
FAV	Kaplowitz, Richard KAP	Year	Written (PDF)
FAV	Delegate Guzzone, Delegate Guzzonelegislator	Individual	Oral
FAV	Elliott, Robynlobbyist	Individual	Written (PDF)
FAV	Kauffman, Dannalobbyist	Individual	Oral + Written (PDF)
FAV	Pellegrino, Richard	Individual	Oral
FAV	Wise, Steve	Individual	Written (PDF)
UNF	Lake, Keith	AHIP - Washington, DC	Written (PDF)
UNF	Robinson, Kimberlylobbyist	CareFirst BlueCross BlueSheild	Oral
UNF	Taylor, Allisonlobbyist	Kaiser Permanente	Oral + Written (PDF)
UNF	Winn, Josephlobbyist	Maryland Managed Care Organization Association	Oral + Written (PDF)
UNF	Johansen, Michaellobbyist	RWL	Oral
UNF	Celentano, Matthewlobbyist	The League of Life and Health Insurers of Maryland	Oral
FWA	Leboe, William	MSDA	Oral
FWA	Prokop, Dr Marla	MSDA	Oral
FWA	Dargan, Stephen	Maryland State Dental Association	Oral
FWA	Doherty, Daniel	Maryland State Dental Association, Maryland Society of Oral & Maxillofacial Surgeons	Oral + Written (PDF)
FWA	Bloch, Richard	Individual	Written (PDF)

Organizations on record

AHIP - Washington, DCUNF 1

CareFirst BlueCross BlueSheildUNF 1

Kaiser PermanenteUNF 1

Licensed Clinical Professional Counselors of MarylandFAV 1

LifeBridge HealthFAV 1

Maryland Hospital AssociationFAV 1

Maryland Legislative CoalitionFAV 1

Maryland Managed Care Organization AssociationUNF 1

Maryland State Dental AssociationFAV 1FWA 1

Maryland State Dental Association, Maryland Society of Oral & Maxillofacial SurgeonsFWA 1

MD Chesapeake Chapter of the National Association of Pediatric Nurse Practitioners (NAPNAP)FAV 1

MedChiFAV 3

MGAFAV 1

MSDAFWA 2

Public Policy PartnersFAV 1

RWLUNF 1

The League of Life and Health Insurers of MarylandUNF 1

University of Maryland Medical SystemFAV 1

YearFAV 1

Registered lobbyists who testified

FAVMansfield, AndreaLicensed Clinical Professional Counselors of MarylandRegistered for: HDR Engineering, Inc.; Adventist HealthCare, Inc.; Alkermes; Alterwood Health, Inc.; American Chemistry Council; Amrize North America Inc., formerly Holcim Participations (US) Inc.…

FAVWhitaker, JakeMaryland Hospital AssociationRegistered for: Maryland Hospital Association

FAVPaddy, MichaelPublic Policy PartnersRegistered for: American Cancer Society Cancer Action Network; Campaign to Protect Patient Health d/b/a Value of Care Coalition; Chase Brexton Health System; Diabetes Patient Advocacy Coalition; Gaudenzia, Inc.; Gilead Sciences, Inc.…

FAVElliott, RobynRegistered for: American Association for Marriage and Family Therapists; Amica Center for Immigrant Rights; CareForth; Chase Brexton Health System; Coordinating Center, The; Diabetes Patient Advocacy Coalition…

FAVKauffman, DannaRegistered for: Amazon.com Services, LLC; American Association of Dental Boards c/o Commission on Dental Competency Assessments; Baltimore Gas and Electric Company; Behavioral Health System Baltimore; City of Rockville; Community Behavioral Health Association of Maryland…

UNFRobinson, KimberlyCareFirst BlueCross BlueSheildRegistered for: CareFirst BlueCross BlueShield; Cigna Corporate Services, LLC

UNFTaylor, AllisonKaiser PermanenteRegistered for: Kaiser Permanente

UNFWinn, JosephMaryland Managed Care Organization AssociationRegistered for: Maryland Managed Care Organization Association; United Healthcare Services, Inc.

UNFJohansen, MichaelRWLRegistered for: 1/ST Racing MD LLC; ASC Engineered Solutions; Access Holdings Management Company, LLC; Alterwood Health, Inc.; Ashley, Inc.; Baltimore Streetcar Museum…

UNFCelentano, MatthewThe League of Life and Health Insurers of MarylandRegistered for: 38 Degrees North; Advanced Energy United; Alliance of Maryland Dental Plans; Allstate Insurance Company; America's Health Insurance Plans; American Council of Life Insurers…