Advocates press for coverage of annual behavioral-health wellness visits; insurers raise workforce and duplication concerns

Sen. Malcolm Augustine presented SB 124 to require the Maryland Medical Assistance Program and other insurers to cover and reimburse an annual behavioral-health wellness visit akin to an annual physical.

Proponents — including clinicians, NAMI Maryland, hospital representatives and community providers — said the visit would allow preventive screening and early intervention without forcing a diagnostic code at the outset. Dr. Shatiya Blunt (private psychotherapist) emphasized ethical issues when clinicians must pathologize normal responses simply to obtain payment. Jake Whitaker of the Maryland Hospital Association said community behavioral-health capacity gaps and avoidable emergency-department visits could be reduced by early access.

Insurers and industry groups (CareFirst, League of Life and Health Insurers) opposed or urged an unfavorable report, saying much of the desired screening already occurs during no-cost annual physicals and in Medicaid collaborative-care models; they warned the state’s behavioral-health workforce shortages could make access difficult and that the MHCC interim review did not recommend separating the visits from primary care. CareFirst suggested the Health Care Commission examine the tradeoffs.

Sponsors and supporters argued the bill fills a parity gap and aligns with other states that have adopted similar preventive behavioral-health measures. The committee took testimony but did not vote that day.