Maryland Insurance Administration

The meeting provided updates on the property and casualty division, including public hearings regarding child care liability insurance and the affordability of insurance. Key internal updates focused on efforts to address the backlog in rate and form filings through increased staffing, actuarial support, and consultant partnerships. Guidance was provided to industry members regarding filing procedures, the use of the rapid response program, and compliance with anti-discrimination statutes. Additionally, the legislative update covered new bills affecting the market, including those related to climate change, peer-to-peer car sharing, and the Maryland Automobile Insurance Fund.

The workgroup focused on pharmacy benefit management topics, specifically reviewing regulations related to specialty drug classifications and reimbursement practices. Participants discussed the impact of anti-steering laws, the challenges posed by ERISA-regulated plans, and the need for a precise definition of specialty drugs. The workgroup also addressed the collection of data to assess the effectiveness of existing statutes and heard updates regarding oversight and enforcement capabilities.

The All-Employee meeting focused on key organizational priorities for the upcoming year, specifically categorized as people, data, processes, and partnership. The leadership team provided an update on the development of an agency-wide policy for the appropriate use of artificial intelligence, including the launch of a pilot program. Additionally, the Property and Casualty division shared significant performance metrics, highlighting successful reductions in pending caseloads and improved efficiency in processing rate and rule filings, while also announcing the transition to an electronic payment system for filing fees.

The meeting focused on the review of the work group's work plan and charges, specifically regarding the reduction of adverse decisions in the state health care system. Key discussion topics included a presentation on Medicare Advantage and CMS rules for utilization management and prior authorization, the impact of these rules on patient care, public transparency requirements for coverage criteria, and the inclusion of health equity analyses in prior authorization processes.

The workgroup meeting focused on selecting a chair, establishing the work plan and timeline for reporting, and receiving presentations from the Maryland Insurance Administration regarding the appeals and grievance process for adverse decisions, as well as an analysis of denials data from the Maryland Hospital Association.