The Maryland Insurance Administration held a public hearing regarding proposed rate increases for individual long-term care insurance policies. The session addressed 11 rate increase applications for policies sold between 1997 and 2014, with presentations from John Hancock Life Insurance Company, Union Security Insurance Company, MedAmerica Insurance Company, and Transamerica Life. Insurance company representatives provided actuarial justifications for the proposed rate hikes, citing higher benefit utilization and lower mortality rates. The administration reviewed the proposals for compliance with state laws, while also outlining mitigation options available to impacted policyholders and providing an opportunity for public comment.
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The workgroup discussed recommendations for state reporting on adverse decisions, including definitions for medical service categories, health settings, and medical necessity. Topics included streamlining reporting for grievances and complaints, developing standardized reporting requirements across payers, and strategies to reduce adverse decisions, such as the use of standardized forms for prior authorizations and appeals. The group also considered the role of third-party audits and the potential implementation of electronic notices for denials.
Aug 25, 2026·Board meeting agenda packet
Pharmacy Benefits Managers Workgroup Meeting
The meeting featured presentations on independent specialty pharmacies and pharmacy accreditation, including definitions and the role of accreditation in quality and safety. Discussion also covered transparency within pharmacy benefit manager reimbursement arrangements, exploring core terms, pricing transparency, and regulatory impacts. Additionally, the workgroup reviewed charge #2 regarding pharmacy reimbursement, comparing Medicaid pharmacy benefit delivery models, including carve-in, single PBM, and fee-for-service carve-out approaches, and analyzed the potential impacts on reimbursement methodology, administrative costs, and rebate structures.
Aug 21, 2026·Board meeting
Maryland Insurance Administration Public Hearing
The public hearing focused on gathering feedback regarding regulations for the submission and processing of clean claims. Key discussion topics included the alignment of current regulations with technological advancements in claim processing and submission, the tracking of claim resubmissions and interest payments, concerns regarding virtual credit card payment methods, the role of documentation such as attachments and itemizations in claim adjudication, and specific challenges related to emergency services billing, including the use of varied autopay lists by managed care organizations.
