Amend Maryland Medical Care Data Base and Data Collection, which govern the submission of healthcare data by payors to Maryland Health Care Commission (MHCC).
Amendments allow the Commission to collect data on all denied health care services.
Maryland Medical Care Data Base (MCDB) is useful but needs to be more complete.
State agency utilization management data covers broad categories but not specific services, such as continuous glucose monitors, and is limited to fully insured market.
The State does not know the service-level information regarding denials and why.
Recommends collecting denied claims across all payors and risk types will give insights to the state on what health care services are denied through utilization management.
Based on feedback from health insurers, MHCC has changed its definition of denied claims from a specified one to a definition that collects all denials for any reason.
This change is comprehensive and reduces administrative burden for health insurers.
Effectiveness
The amendments take effect on Oct. 12, 2026.
Regulators
MD INS
Entity Types
Ins
Reference
MD SR Vol. 53 Is. 20, RF 26-088-F, 10/2/2026; MD SR Vol. 53 Is. 13, RF 26-088-P, 6/26/2026; Citation: *MD INS* 10.25.06.02, 10.25.06.05;
