02 OFFICE OF THE ATTORNEY GENERAL

02.01.05.02, .04 • 53:9 Md. R. 415 (5-01-26)

02.01.11.01—.03 • 53:9 Md. R. 416 (5-01-26)

05 DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT

05.24.01.01—.04 • 52:13 Md. R. 660 (6-27-25)

08 DEPARTMENT OF NATURAL RESOURCES

08.01.07.10 • 52:17 Md. R 878 (8-22-25)

• 53:6 Md. R. 294 (3-20-26)

08.01.10.01—.06 • 52:17 Md. R 878 (8-22-25)

• 53:6 Md. R. 294 (3-20-26)

08.02.11.04 • 53:7 Md. R. 330 (4-3-26)

08.02.21.02 • 53:7 Md. R. 330 (4-3-26)

08.07.01.25 • 52:17 Md. R 878 (8-22-25)

• 53:6 Md. R. 294 (3-20-26)

08.07.06.25 • 52:17 Md. R 878 (8-22-25)

• 53:6 Md. R. 294 (3-20-26)

08.18.01.04 • 53:8 Md. R. 358 (4-17-26)

09 MARYLAND DEPARTMENT OF LABOR

09.03.09.06 • 52:7 Md. R. 328 (4-4-25)

09.03.10.01, .06 • 53:7 Md. R. 331 (4-3-26)

09.08.01.01, .03, .04, .28 • 53:2 Md. R. 70 (1-23-26)

09.08.06.02 • 53:2 Md. R. 70 (1-23-26)

09.08.07.02 • 53:2 Md. R. 70 (1-23-26)

09.10.03.01-2, .01-3 • 52:24 Md. R 1206 (12-01-25)

09.10.03.09 • 53:2 Md. R. 71 (1-23-26)

09.11.07.01 • 52:12 Md. R. 600 (6-13-25)

• 53:6 Md. R. 295 (3-20-26)

09.12.21.01, .02, .04 • 53:5 Md. R. 247 (3-06-26)

09.12.57.02 • 53:1 Md. R. 30 (1-09-26) (ibr)

09.14.06.16 • 53:6 Md. R. 296 (3-20-26)

09.19.02.04 • 53:1 Md. R. 31 (1-09-26)

09.19.02.04 • 53:8 Md. R. 359 (4-17-26)

09.22.02.03, .05 • 52:6 Md. R. 273 (3-21-25)

• 52:16 Md. R. 850 (8-8-25)

09.30.01, .01—.10 • 52:2 Md. R 371 (4-18-25)

09.38.01.05 • 53:3 Md. R. 125 (2-6-26)

10 MARYLAND DEPARTMENT OF HEALTH

Subtitles 01—08 (1st volume)

10.01.07.01, .02, .04—.10 • 52:24 Md.R 1207 (12-01-25) (ibr)

10.04.01.01, .04 • 53:4 Md. R. 192 (2-20-26)

10.07.01.01,.38, .39 • 52:22 Md. R. 1104 (10-31-25)

10.07.04 .02, .04, .17 • 52:26 Md. R. 1345 (12-26-25)

Subtitle 09 (2nd volume)

10.09.02.07 • 53:8 Md. R. 360 (4-17-26) (ibr)

10.09.08.01 • 53:5 Md. R. 248 (3-06-26)

10.09.10,. 01, .07,.08, .12—.15, .31 • 53:8 Md. R. 360 (4-17-26)

10.09.29.01,.04 • 53:5 Md. R. 248 (3-06-26)

10.09.45.02—.04, .08 • 53:5 Md. R. 248 (3-06-26)

10.09.46, .12 • 52:25 Md. R. 1278 (12-12-25)

10.09.49.02, .07, .08 • 52:26 Md. R. 1346 (12-26-25)

10.09.59.05,.06 • 53:5 Md. R. 248 (3-06-26)

10.65.12.01—.04 • 53:8 Md. R. 363 (4-17-26)

10.09.89.02,.03,.05,.07,.09—.18 • 53:5 Md. R. 251 (3-06-26)

10.09.90.02, .07, .08, .11, .13 • 53:5 Md. R. 256 (3-06-26)

10.09.90.17 • 53:5 Md. R. 248 (3-06-26)

Subtitles 10—22 (3rd volume)

10.10.13.12 • 53:5 Md. R. 257 (3-06-26)

Subtitles 23—36 (4th volume)

10.25.03.02 • 53:7 Md. R. 332 (4-3-26)

10.25.10.07 • 53:6 Md. R. 296 (3-20-26)

10.25.17.01—.07 • 53:9 Md. R. 416 (5-01-26)

10.27.02.01 • 52:12 Md. R. 609 (6-13-25)

10.27.05.07 • 52:12 Md. R. 609 (6-13-25)

10.27.10.02 • 52:16 Md. R. 856 (8-8-25)

10.27.12.02, .05, .06, .09 • 53:9 Md. R. 418 (5-01-26)

10.27.18.01,.02 • 52:12 Md. R. 609 (6-13-25)

10.27.26.02 • 52:12 Md. R. 609 (6-13-25)

10.27.27.01, .04, .06; .07 • 53:9 Md. R. 418 (5-01-26)

10.32.05.02—.06 • 52:11 Md. R. 563 (5-30-25)

10.32.25.01—.06 • 52:13 Md. R. 670 (6-27-25)

10.34.02.02,.03 • 52:24 Md. R 1215 (12-01-25)

10.34.19.01—.03, .05—.19 • 52:23 Md. R. 1164 (11-14-25)

Subtitles 37—52 (5th volume)

10.39.01.01—.11 • 53:5 Md. R. 258 (3-06-26)

10.39.02.01—.11 • 53:5 Md. R. 258 (3-06-26)

10.39.03.01,.02 • 53:5 Md. R. 258 (3-06-26)

10.41.02.02, .04 • 53:9 Md. R. 420 (5-01-26)

10.41.03.02, .03, .06 • 53:9 Md. R. 420 (5-01-26)

10.41.05.02, .04, .05—.08 • 53:9 Md. R. 420 (5-01-26)

10.41.07.02—.05 • 53:9 Md. R. 420 (5-01-26)

10.41.08.01-1, .02—.15 • 53:9 Md. R. 420 (5-01-26)

10.41.11.01, .06, .07, .09, .10, .13 • 53:9 Md. R. 420 (5-01-26)

10.41.12.03, .04 • 53:9 Md. R. 420 (5-01-26)

10.42.02.02,06 • 52:14 Md. R 720 (7-11-25)

10.44.01.01—.30 • 52:17 Md. R 882 (8-22-25)

10.44.20.02 • 52:23 Md. R.1171 (11-14-25)

10.52.12.05 • 53:5 Md. R. 257 (3-06-26)

Subtitles 53—69 (6th volume)

10.65.07.02 • 52:14 Md. R 721 (7-11-25)

10.65.12.01—.05 • 52:14 Md. R 721 (7-11-25)

10.67.03.08 • 53:9 Md. R. 425 (5-01-26)

10.67.04.02, .03-2, .20 • 53:9 Md. R. 425 (5-01-26)

10.67.06.07, .28 • 53:9 Md. R. 425 (5-01-26)

10.67.08.02 • 53:5 Md. R. 248 (3-06-26)

10.67.09.02, .04 • 53:9 Md. R. 425 (5-01-26)

10.69.01.01—.13 • 52:12 Md. R. 609 (6-13-25)

10.69.02.01—.06 • 52:12 Md. R. 609 (6-13-25)

10.69.03.01—.03 • 52:12 Md. R. 609 (6-13-25)

11 DEPARTMENT OF TRANSPORTATION

Subtitles 1—10

11.03.01.01-1, .12 • 53:6 Md. R. 297 (3-20-26)

11.03.02.01 • 53:6 Md. R. 297 (3-20-26)

11.04.15.01—.04 • 52:11 Md. R. 568 (5-30-25)

Subtitles 11—23 (MVA)

11.11.05.02—.04, .06 • 52:13 Md. R. 682 (6-27-25)

11.13.13.01—.03 • 52:2 Md. R. 126 (1-24-25) (err)

11.14.01.01—.18 • 52:14 Md. R 723 (7-11-25)

11.14.02.01—.29 • 52:14 Md. R 723 (7-11-25)

11.14.03.01—.14 • 52:14 Md. R 723 (7-11-25)

11.14.04.01—.23 • 52:14 Md. R 723 (7-11-25)

11.14.05.01—.11 • 52:14 Md. R 723 (7-11-25)

11.14.06.01—.07 • 52:14 Md. R 723 (7-11-25)

12 DEPARTMENT OF PUBLIC SAFETY AND CORRECTIONAL SERVICES

12.08.03.01—.06 • 53:8 Md. R. 363 (4-17-26)

13A STATE BOARD OF EDUCATION

13A.01.02.07 • 53:8 Md. R. 365 (4-17-26)

13A.02.01.05 • 53:8 Md. R. 366 (4-17-26)

13A.12.05.05, .06, .10 • 53:8 Md. R. 367 (4-17-26)

13A.01.05.12,.13 • 53:6 Md. R. 298 (3-20-26)

13A.02.01.01 • 52:26 Md. R. 1350 (12-26-25)

13A.02.10.01—.16 • 53:4 Md. R. 202 (2-20-26)

13A.05.04.01—.03 • 52:17 Md. R 889 (8-22-25)

• 53:3 Md. R. 126 (2-6-26)

13A.08.01.05 • 53:4 Md. R. 207 (2-20-26)

13A.08.01.10-1 • 53:3 Md. R. 127 (2-6-26)

13A.15.01.02 • 52:23 Md. R. 1173 (11-14-25)

13A.15.04.03 • 52:23 Md. R. 1173 (11-14-25)

13A.15.16.01—.10 • 52:23 Md. R. 1173 (11-14-25)

14 INDEPENDENT AGENCIES

14.04.05.05 • 53:6 Md. R. 299 (3-20-26)

14.04.11.01,.02 • 53:6 Md. R. 299 (3-20-26)

14.22.01.01, .02, .10 • 53:9 Md. R. 427 (5-01-26)

14.22.02.02 • 53:9 Md. R. 427 (5-01-26)

14.23.01.01, .19 • 53:3 Md. R. 128 (2-6-26)

14.35.15.08 • 53:7 Md. R. 332 (4-3-26)

14.39.02.06 • 52:17 Md. R 900 (8-22-25)

14.41.01.01— 16 • 52:10 Md. R. 472 (5-16-25)

15 MARYLAND DEPARTMENT OF AGRICULTURE

15.06.04.02—.07 • 53:2 Md. R. 81 (1-23-26) (ibr)

17 DEPARTMENT OF BUDGET AND MANAGEMENT

17.04.03.22 • 53:8 Md. R. 367 (4-17-26)

17.04.11.31 • 53:1 Md. R. 38 (1-09-26)

18 DEPARTMENT OF ASSESSMENTS AND TAXATION

18.02.03.05 • 53:6 Md. R. 301 (3-20-26)

19A STATE ETHICS COMMISSION

19A.06.01.01,.02 • 53:6 Md. R. 301 (3-20-26)

19A.06.02.01 • 53:6 Md. R. 301 (3-20-26)

19A.06.03.01 • 53:6 Md. R. 301 (3-20-26)

19A.06.04.01—.08 • 53:6 Md. R. 301 (3-20-26)

21 STATE PROCUREMENT REGULATIONS

21.01.01.01 • 53:8 Md. R. 368 (4-17-26)

21.01.02.01 • 53:8 Md. R. 368 (4-17-26)

21.01.03.01, .01-1 • 53:8 Md. R. 368 (4-17-26)

21.02.01.04, .05 • 53:8 Md. R. 368 (4-17-26)

21.05.01.01 • 53:8 Md. R. 368 (4-17-26)

21.05.02.04, .07, .16 • 53:8 Md. R. 368 (4-17-26)

21.05.03.03 • 53:8 Md. R. 368 (4-17-26)

21.05.06.01—.03 • 53:8 Md. R. 368 (4-17-26)

21.05.07.01, .03, .04, .05 • 53:8 Md. R. 368 (4-17-26)

21.05.08.02 • 53:8 Md. R. 368 (4-17-26)

21.05.09.05 • 53:8 Md. R. 368 (4-17-26)

21.05.10.05 • 53:8 Md. R. 368 (4-17-26)

21.05.12.03, .04 • 53:8 Md. R. 368 (4-17-26)

21.05.13.01, .03, .05, .06, .07, .08 • 53:8 Md. R. 368 (4-17-26)

21.05.15.01—.05 • 53:8 Md. R. 368 (4-17-26)

21.06.07.01, .09, .10 • 53:8 Md. R. 368 (4-17-26)

21.06.09.05 • 53:8 Md. R. 368 (4-17-26)

21.06.10.01—.05 • 53:8 Md. R. 368 (4-17-26)

21.07.01.18, .19, .24, .27, .28 • 53:8 Md. R. 368 (4-17-26)

21.07.02.05-1, .10, .11 • 53:8 Md. R. 368 (4-17-26)

21.07.04.02 • 53:8 Md. R. 368 (4-17-26)

21.10.04.04 • 53:8 Md. R. 368 (4-17-26)

21.11.01.01, .06 • 53:8 Md. R. 368 (4-17-26)

21.11.03.01, .03, .04, .07, .08, .09, .11, .12, .13, .15, .17 • 53:8 Md. R. 368 (4-17-26)

21.11.05.01, .06, .07 • 53:8 Md. R. 368 (4-17-26)

21.11.07.08, .11 • 53:8 Md. R. 368 (4-17-26)

21.11.12.03, .04 • 53:8 Md. R. 368 (4-17-26)

21.12.02.05 • 53:8 Md. R. 368 (4-17-26)

21.13.01.02, .03, .15 • 53:8 Md. R. 368 (4-17-26)

24 DEPARTMENT OF COMMERCE

24.05.01.06, .08, .10 • 53:1 Md. R. 42 (1-09-26)

26 DEPARTMENT OF THE ENVIRONMENT

Subtitles 01—07 (Part 1)

26.04.14.01—.12 • 53:3 Md. R. 129 (2-6-26)

Subtitles 08—12 (Part 2)

26.11.09.01, .07 • 52:12 Md. R. 627 (6-13-25)

Subtitles 13—18 (Part 3)

26.13.01.03—.05 • 52:10 Md. R. 478 (5-16-25)

26.13.02.01, .04, .04-1, .04-7, .05, .06, .07, .07-1, .11, .13, .16, .19,.23 • 52:10 Md. R. 478 (5-16-25)

26.13.03.01,.01-1,.02,.03-3,.03-4,.03-5,.03-7,.05,.05-4,.06 • 52:10 Md. R. 478 (5-16-25)

26.13.04.01 • 52:10 Md. R. 478 (5-16-25)

26.13.05.01, .04, .05,.14 • 52:10 Md. R. 478 (5-16-25)

26.13.06.01, .02, .05, .22 • 52:10 Md. R. 478 (5-16-25)

26.13.07.01, .02, .02-6, ,17, .20,.20-1—.20-6 • 52:10 Md. R. 478 (5-16-25)

26.13.09.01 • 52:10 Md. R. 478 (5-16-25)

26.13.10.01, .04, .06, .08, .09-1,.14, .16-1, .17, .19, .20, .25, .32—.49 • 52:10 Md. R. 478 (5-16-25)

26.13.11.01 • 52:10 Md. R. 478 (5-16-25)

26.16.08.05 • 52:26 Md. R. 1352 (12-26-25)

30 MARYLAND INSTITUTE FOR

EMERGENCY MEDICAL SERVICES SYSTEMS (MIEMSS)

30.01.02.01 • 53:7 Md. R. 333 (4-3-26) (ibr)

31 MARYLAND INSURANCE ADMINISTRATION

31.03.20.01—.03 • 53:7 Md. R. 334 (4-3-26)

33 STATE BOARD OF ELECTIONS

33.05.01.04 • 52:13 Md. R. 690 (6-27-25)

33.07.07.01—.03 • 52:25 Md. R. 1280 (12-12-25)

33.07.11.01 • 52:13 Md. R. 690 (6-27-25)

33.14.02.14 • 52:5 Md. R. 249 (3-7-25)

• 52:15 Md. R. 821 (7-25-25)

33.22.01.01 • 53:7 Md. R. 334 (4-3-26)

33.22.02.01 • 53:7 Md. R. 334 (4-3-26)

34 DEPARTMENT OF PLANNING

34.04.07.02, .03, .05 • 52:25 Md. R. 1285 (12-12-25)

36 MARYLAND STATE LOTTERY AND GAMING CONTROL AGENCY

36.03.06.01, .03 • 52:26 Md. R. 1353 (12-26-25)

36.03.10.38 • 52:26 Md. R.1353 (12-26-25)

36.04.01.13 • 53:8 Md. R. 387 (4-17-26)

36.07.04.14 • 52:26 Md. R. 1353 (12-26-25)

36.07.06.08 • 52:26 Md. R. 1353 (12-26-25)

36.10.10.01 • 52:26 Md. R.1353 (12-26-25)

36.10.13.29, .41 • 52:26 Md. R. 1353 (12-26-25)

36.10.13.39 • 52:17 Md. R 908 (8-22-25)

The General Assembly

For additional up-to-date information concerning bills introduced in the General Assembly, log on to http://mlis.state.md.us and click on Bill Information and Status. You may then enter a specific bill number for information about that bill. You may also click on Senate Synopsis or House Synopsis for the most recent synopsis list for each house, or click on Synopsis Index for a listing of all bill synopses since the beginning of the legislative session.

SYNOPSIS No. 7

Chapters

CH0004 SB0282 (Enrolled) The Pres (Admin). Budget Bill (Fiscal Year 2027).

CH0005 SB0283 (Enrolled) The Pres (Admin). Creation of a State Debt – Maryland Consolidated Capital Bond Loan of 2026, and the Maryland Consolidated Capital Bond Loans of 2014, 2015, 2016, 2017, 2018, 2019, 2020, 2021, 2022, 2023, 2024, and 2025.

CH0006 SB0284 (Enrolled) The Pres (Admin). Budget Reconciliation and Financing Act of 2026.

CH0007 HB0637 (Amended) The Spkr (Admin), et al. Public Health - Recommendations for Immunizations, Screenings, and Preventive Services - Pharmacist Administration and Required Health Insurance Coverage (The Vax Act).

CH0008 SB0385 (Amended) The Pres (Admin), et al. Public Health - Recommendations for Immunizations, Screenings, and Preventive Services - Pharmacist Administration and Required Health Insurance Coverage (The Vax Act).

CH0009 HB1221 (Amended) Dels Foley and Hutchinson. Public Safety - Short-Term Rental Units - Safety (Jillian and Lindsay Wiener Short-Term Rental Safety Act).

CH0010 SB0624 (Amended) Sen Feldman. Public Safety - Short-Term Rental Units - Safety (Jillian and Lindsay Wiener Short-Term Rental Safety Act).

CH0011 HB0280 Chr HLT (Dept). Health Insurance - Mental Health and Substance Use Disorders - Codification of Federal Requirements.

CH0012 SB0205 Chr FIN (Dept). Health Insurance - Mental Health and Substance Use Disorders - Codification of Federal Requirements.

CH0013 SB0861 (Amended) Sens Zucker and Feldman. Environment - Stormwater Management for Agritourism.

CH0014 HB1071 (Amended) Del Foley, et al. Environment - Stormwater Management for Agritourism.

CH0015 HB0804 (Amended) Del Wolek, et al. Department of Aging - Aging Resilience Fund - Establishment.

CH0016 SB0860 (Amended) Sen Zucker, et al. Department of Aging – Aging Resilience Fund – Establishment.

CH0017 HB1142 Del Wilkins. Task Force to Modernize County and Municipal Revenue Structures.

CH0018 HB0472 (Amended) Del Feldmark, et al. Income Tax - Theatrical Production Tax Credit - Alterations and Sunset Extension.

CH0019 SB0440 (Enrolled) Sen Guzzone, et al. Income Tax - Theatrical Production Tax Credit - Alterations and Sunset Extension.

CH0020 HB0118 Del Queen. Maryland Money Transmission Act - Definition of Money Transmitter - Alteration.

CH0021 SB0261 Sen Beidle. Maryland Money Transmission Act - Definition of Money Transmitter - Alteration.

CH0022 SB0492 (Amended) Sen Beidle. Health Occupations - Massage Therapy - Advertising.

CH0023 HB0975 (Amended) Del Guzzone, et al. Health Occupations - Massage Therapy - Advertising.

CH0024 HB1002 (Amended) Del Lopez, et al. Nursing Facilities - Involuntary Discharge or Transfer.

CH0025 SB0493 (Amended) Sen Beidle. Nursing Facilities - Involuntary Discharge or Transfer.

CH0026 HB0380 Del S. Johnson. State Board of Examiners in Optometry - Examination Requirements and Time Period for Inactive Status.

CH0027 SB0186 Sen Augustine. State Board of Examiners in Optometry - Examination Requirements and Time Period for Inactive Status.

CH0028 SB0907 (Amended) Sen Love, et al. Public Health - Female Genital Mutilation.

CH0029 HB1389 Del D. Jones, et al. Public Health - Female Genital Mutilation.

CH0030 HB0007 Del Guzzone. State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists - Authority to Issue Limited Licenses to Practice Music Therapy.

CH0031 SB0088 Sen Gile. State Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists - Authority to Issue Limited Licenses to Practice Music Therapy.

CH0032 SB0293 (Amended) Sen Jackson. Professional Liability Insurance Coverage - Nursing Homes, Assisted Living Facilities, Nurse Midwives, and Licensed Certified Midwives - Disclosure (Nyeli Rose Lewis Act of 2026).

CH0033 HB0442 (Amended) Del Kaufman, et al. Professional Liability Insurance Coverage - Nursing Homes, Assisted Living Facilities, Nurse Midwives, and Licensed Certified Midwives - Disclosure (Nyeli Rose Lewis Act of 2026).

CH0034 HB0957 (Amended) Del Wu, et al. Cybersecurity - Standards and Compliance - Alterations.

CH0035 SB0601 (Amended) Sen Hester, et al. Cybersecurity - Standards and Compliance - Alterations.

CH0036 SB0363 Sen Mautz. Maryland-Ireland Trade Commission - Membership and Termination - Altered and Extended.

CH0037 HB0413 Del Kerr, et al. Maryland-Ireland Trade Commission - Membership and Termination - Altered and Extended.

CH0038 HB0322 (Amended) Del Kerr, et al. Maryland Health Care Commission - Membership.

CH0039 SB0260 (Amended) Sen Jackson. Maryland Health Care Commission - Membership.

CH0040 SB0784 Sen Jackson. Financial Institutions - Consumer Credit - Application of Licensing Requirements.

CH0041 HB0947 (Amended) Del Sample-Hughes, et al. Natural Resources - Invasive Blue Catfish Pilot Program - Alterations.

CH0042 SB0610 (Amended) Sen Mautz. Natural Resources - Invasive Blue Catfish Pilot Program - Alterations.

CH0043 SB0910 (Amended) Sen Mautz. Health Insurance - Graduate-Level Clinical Interns - Required Reimbursement.

CH0044 HB1094 (Amended) Del Hutchinson, et al. Health Insurance - Graduate-Level Clinical Interns - Required Reimbursement.

CH0045 HB0734 (Amended) Del Roberson. Property Tax - Agricultural Use Assessment - Community Solar Energy Generating Systems.

CH0046 SB0344 (Amended) Sens King and Hester. Property Tax - Agricultural Use Assessment - Community Solar Energy Generating Systems.

CH0047 HB0452 Del Guyton, et al. State Board of Veterinary Medical Examiners - Grounds for Disciplinary Action - Restrictions.

CH0048 SB0054 Sen Lam. State Board of Veterinary Medical Examiners - Grounds for Disciplinary Action - Restrictions.

CH0049 SB0395 (Amended) Sen Gile. Peer-to-Peer Car Sharing Programs - Insurance and Liability.

CH0050 HB1186 (Amended) Del Rogers, et al. Peer-to-Peer Car Sharing Programs - Insurance and Liability.

CH0051 SB0272 Sen Gile. Health Insurance - Scalp Cooling Systems - Required Coverage.

CH0052 HB0393 Del Nkongolo, et al. Health Insurance - Scalp Cooling Systems - Required Coverage.

CH0053 HB0838 (Amended) Del Cullison, et al. State Board of Pharmacy - Prescriber-Pharmacist Agreements.

CH0054 SB0562 (Amended) Sen Gile. State Board of Pharmacy - Prescriber-Pharmacist Agreements - Treatment of Opioid Use Disorders.

CH0055 SB0724 Sen Lewis Young. State Retirement and Pension System - Cost-of-Living Adjustments - Clarification.

CH0056 HB1138 Del Forbes. State Retirement and Pension System – Cost–of–Living Adjustments – Clarification.

CH0057 HB0872 Del Coley, et al. Law Enforcement Officers' Pension System - Seat Pleasant Police Department.

CH0058 HB0720 (Amended) Del Patterson, et al. Higher Education - Douglas J. J. Peters Veterans of the Afghanistan and Iraq Conflicts Scholarship - Repeal of Termination Date.

CH0059 SB0007 (Amended) Sen Simonaire, et al. Higher Education - Douglas J. J. Peters Veterans of the Afghanistan and Iraq Conflicts Scholarship - Repeal of Termination Date.

CH0060 SB0262 (Amended) Sen Simonaire, et al. Income Tax - Subtraction Modification for Classroom Supplies Purchased by Teachers - Alteration.

CH0061 HB0478 (Amended) Del Patterson, et al. Income Tax - Subtraction Modification for Classroom Supplies Purchased by Teachers - Alteration.

CH0062 SB0123 (Amended) Sen Simonaire. Oversight Committee on Quality of Care in Nursing Homes and Assisted Living Facilities - Membership.

CH0063 HB0747 (Amended) Del Kipke, et al. Oversight Committee on Quality of Care in Nursing Homes and Assisted Living Facilities – Membership.

CH0064 HB0343 (Amended) Del Rosenberg. Housing Development Projects - Housing Counseling Services.

CH0065 SB0136 (Amended) Sens Kramer and Bailey. Collective Bargaining - Alcohol, Tobacco, and Cannabis Commission - Police Officers.

CH0066 HB0848 Del Stein. Public Safety – State Fire Prevention Code – Trash and Recyclable Materials.

CH0067 SB0621 Sens Watson and Salling. Public Safety - State Fire Prevention Code - Trash and Recyclable Materials.

CH0068 SB0444 Sen Kramer. Certificate of Need - Intermediate Health Care Facilities.

CH0069 HB0498 Del Cullison. Certificate of Need - Intermediate Health Care Facilities.

CH0070 HB0619 Del Cullison. Interstate Podiatric Medical Licensure Compact.

CH0071 SB0333 Sen Kramer. Interstate Podiatric Medical Licensure Compact.

CH0072 HB0174 Del Cardin. Motor Vehicles and Marine Vessels - Transfer-on-Death Designations.

CH0073 SB0145 Sen West. Motor Vehicles and Marine Vessels - Transfer-on-Death Designations.

CH0074 HB0020 Del Amprey. Baltimore City - Alcoholic Beverages - Related Event Promoter's Permit.

CH0075 HB0225 Chr APP (Dept). Maryland Horse Industry Board - Sunset Extension.

CH0076 HB0254 Chr ENT (Dept). Supporting Inclusive Community Adaptation Act.

CH0077 HB0227 Chr APP (Dept). Maryland Environmental Service - Authorizations and Requirements - Alterations.

CH0078 SB0228 Chr Education, Energy, and the Environmen. Maryland Environmental Service - Authorizations and Requirements - Alterations.

CH0079 HB0247 (Amended) Chr ENT (Dept), et al. Chesapeake and Atlantic Coastal Bays Critical Area Protection Program - Variances - Alterations.

CH0080 HB0286 Chr JUD (Dept). Vehicle Laws - Ignition Interlock System Program - Required Participation.

CH0081 SB0038 Chr JPR (Dept). Vehicle Laws - Ignition Interlock System Program - Required Participation.

CH0082 HB1578 (Amended) Chr GVC (Dept). State Procurement - Procurement Preferences - Reauthorization and Revisions.

CH0083 HB0228 Chr APP (Dept). Horse Racing - Prohibited Acts - Slaughter of Racehorses for Commercial Purposes.

CH0084 SB0231 Chr B&T (Dept). Horse Racing - Prohibited Acts - Slaughter of Racehorses for Commercial Purposes.

CH0085 HB0284 (Enrolled) Chr JUD (Dept). Public Safety - Licensed Firearms Dealers - Notification Regarding Compromising Events.

CH0086 SB0160 (Amended) Chr JPR (Dept). Public Safety - Licensed Firearms Dealers - Notification Regarding Compromising Events.

CH0087 SB0176 (Amended) Chr B&T (Dept). Video Lottery Facility Payouts - Intercepts for Restitution Payments, Child Support Payments, and Debts Owed to the State.

CH0088 HB0289 (Amended) Chr W&M (Dept). Video Lottery Facility Payouts - Intercepts for Restitution Payments, Child Support Payments, and Debts Owed to the State.

CH0089 HB0226 (Amended) Chr APP (Dept). Department of Disabilities - Housing Programs and Affiliated Foundations - Establishment.

CH0090 SB0022 (Enrolled) Chr FIN (Dept). Department of Disabilities - Housing Programs and Affiliated Foundations - Establishment.

CH0091 HB0276 (Amended) Chr HLT (Dept). State Emergency Medical Services Board - Public Access Automated External Defibrillator Program - Revisions.

CH0092 SB0024 (Amended) Chr Education, Energy, and the Environmen. State Emergency Medical Services Board - Public Access Automated External Defibrillator Program - Revisions.

CH0093 HB0278 (Amended) Chr HLT (Dept). Human Services - Department of Aging and Commission on Aging (The Longevity Ready Maryland Act).

CH0094 SB0113 (Enrolled) Chr FIN (Dept). Human Services - Department of Aging and Commission on Aging (Longevity Ready Maryland Act).

CH0095 HB0648 Chr ENT (Dept). Office of Home Energy Programs - Uniform Redetermination Process - Age.

CH0096 HB0301 (Amended) Chr GVC (Dept). Maryland Military Department – Supervision of State Active Duty Personnel.

CH0097 SB0128 (Amended) Chr Education, Energy, and the Environmen. Maryland Military Department - Supervision of State Active Duty Personnel.

CH0098 HB0231 Chr APP (Dept). Higher Education - Guaranteed Access Grant Program - Applicability.

CH0099 SB0207 Chr Education, Energy, and the Environmen. Higher Education - Guaranteed Access Grant Program - Applicability.

CH0100 HB0293 (Amended) Chr W&M (Dept). Maryland Longitudinal Data System Center - External Data Sharing With Third-Party Data Centers for Multistate Reporting - Authorization.

CH0101 SB0056 (Amended) Chr Education, Energy, and the Environmen. Maryland Longitudinal Data System Center - External Data Sharing With Third-Party Data Centers for Multistate Reporting - Authorization.

CH0102 HB0269 Chr GVC (Dept). Maryland Public Ethics Law - Financial Disclosure Statements - State Officials of and Candidates to Be a State Official of the Judicial Branch.

CH0103 SB0080 Chr Education, Energy, and the Environmen. Maryland Public Ethics Law - Financial Disclosure Statements - State Officials of and Candidates to Be a State Official of the Judicial Branch.

CH0104 HB0262 (Amended) Chr GVC (Dept). State Government – Council for Open Data – Membership and Responsibilities.

CH0105 SB0200 (Amended) Chr Education, Energy, and the Environmen. State Government - Council for Open Data - Membership and Responsibilities.

CH0106 HB0263 Chr GVC (Dept). Election Law - Early Voting Centers - Bus Stops.

CH0107 SB0100 Chr Education, Energy, and the Environmen. Election Law - Early Voting Centers - Bus Stops.

CH0108 HB0265 Chr GVC (Dept). State Board of Elections - Address Confidentiality Program - Designation of Contact Person.

CH0109 SB0091 Chr Education, Energy, and the Environmen. State Board of Elections - Address Confidentiality Program - Designation of Contact Person.

CH0110 HB0243 (Amended) Chr ECM (Dept). Land Use - Comprehensive and General Plans - Alteration of Elements.

CH0111 SB0197 (Amended) Chr Education, Energy, and the Environmen. Land Use - Comprehensive and General Plans - Alteration of Elements.

CH0112 HB0255 (Amended) Chr ENT (Dept), et al. Natural Resources - Pamela J. Kelly Tree-Mendous Maryland Program - Alterations.

CH0113 SB0164 (Enrolled) Chr Education, Energy, and the Environmen. Natural Resources - Pamela J. Kelly Tree-Mendous Maryland Program - Alterations.

CH0114 HB0229 Chr APP (Dept). Maryland Transportation Authority - Revenue Bond Limit - Increase.

CH0115 SB0188 Chr B&T (Dept). Maryland Transportation Authority - Revenue Bond Limit - Increase.

CH0116 HB0248 Chr ENT (Dept). Motor Vehicle Administration - Identification Cards, Licenses, and Permits - Repeal of Color Photograph Requirement.

CH0117 SB0087 Chr JPR (Dept). Motor Vehicle Administration - Identification Cards, Licenses, and Permits - Repeal of Color Photograph Requirement.

CH0118 HB0251 Chr ENT (Dept). Vehicle Laws - Transfer of Used Vehicles - Repeal of Notarized Bill of Sale Requirement.

CH0119 SB0125 Chr JPR (Dept). Vehicle Laws - Transfer of Used Vehicles - Repeal of Notarized Bill of Sale Requirement.

CH0120 HB0253 (Amended) Chr ENT (Dept). Vehicle Laws - Heavy Weight Port Corridor Permits - Regulations.

CH0121 SB0149 Chr JPR (Dept). Vehicle Laws - Heavy Weight Port Corridor Permits - Regulations.

CH0122 HB0240 Chr ECM (Dept). Local Comprehensive Plans - Guidance Materials and Notification to the Department of Planning.

CH0123 HB0238 Chr ECM (Dept). Maryland Heritage Area Authority and Heritage Areas - Alterations.

CH0124 SB0226 Chr FIN (Dept). Maryland Heritage Area Authority and Heritage Areas - Alterations.

CH0125 HB0236 Chr ECM (Dept). State Athletic Commission - Blood Testing of Contestants - Timing.

CH0126 SB0032 Chr Education, Energy, and the Environmen. State Athletic Commission - Blood Testing of Contestants - Timing.

CH0127 HB0241 Chr ECM (Dept). Business Occupations and Professions - State Boards and Commissions - Sunset Extensions.

CH0128 SB0133 Chr Education, Energy, and the Environmen. Business Occupations and Professions - State Boards and Commissions - Sunset Extensions.

CH0129 HB0242 Chr ECM (Dept). Unemployment Insurance - Confidentiality of Information.

CH0130 SB0216 Chr FIN (Dept). Unemployment Insurance - Confidentiality of Information.

CH0131 HB0259 Chr ECM (Dept). Financial Institutions - Maryland Community Investment Venture Fund and Regulation of Entities - Revisions.

CH0132 SB0043 Chr FIN (Dept). Financial Institutions - Maryland Community Investment Venture Fund and Regulation of Entities - Revisions.

CH0133 HB0234 Chr APP (Dept). Public Safety - Police Employees and Deputy State Fire Marshals - Repeal of Pay Rate Restriction on Promotion.

CH0134 SB0074 Chr JPR (Dept). Public Safety - Police Employees and Deputy State Fire Marshals - Repeal of Pay Rate Restriction on Promotion.

CH0135 HB0274 Chr HLT (Dept). State Board of Environmental Health Specialists - Sunset Extension.

CH0136 SB0119 Chr Education, Energy, and the Environmen. State Board of Environmental Health Specialists - Sunset Extension.

CH0137 HB0273 Chr HLT (Dept). Health Insurance – Small Business Health Options Program (SHOP) Enrollment – Effective Dates.

CH0138 SB0014 Chr FIN (Dept). Health Insurance - Small Business Health Options Program (SHOP) Enrollment - Effective Dates.

CH0139 HB0275 Chr HLT (Dept). Medicare Supplement Policies - Issuance - Requirements.

CH0140 SB0134 Chr FIN (Dept). Medicare Supplement Policies - Issuance - Requirements.

CH0141 HB0277 Chr HLT (Dept). Insurance – Third Party Administrators – Enforcement.

CH0142 SB0139 Chr FIN (Dept). Insurance - Third Party Administrators - Enforcement.

CH0143 HB0232 Chr APP (Dept). Maryland Military Department – National Guard – Tuition Assistance.

CH0144 SB0142 Chr Education, Energy, and the Environmen. Maryland Military Department - National Guard - Tuition Assistance.

CH0145 HB1232 (Enrolled) Del Edelson (BCA), et al. Baltimore City - Economic Development Project in Downtown RISE District - Payment in Lieu of Taxes.

CH0146 SB0756 (Enrolled) Sen McCray (BCA). Baltimore City – Economic Development Project in Downtown RISE District – Payment in Lieu of Taxes.

CH0147 HB1095 Calvert County Delegation. Calvert County - Property Tax Credit - Tobacco Barns.

CH0148 HB1155 Calvert County Delegation. Calvert County - Procurement - Long-Term Contracts for Infrastructure and Asset Management.

CH0149 HB1623 Montgomery County Delegation. Special Taxing Districts - Village of Drummond - Authority and Organization MC 20-26.

CH0150 HB1428 Del Anderson. Somerset County Board of Education - Alterations.

CH0151 SB0508 (Amended) Sen Carozza. Somerset County Board of Education - Alterations.

CH0152 HB0554 The Spkr. General Assembly - Legislative Committees - Renaming and Legislative Policy Committee Membership.

CH0153 SB0844 The Pres (DLS). Annual Corrective Bill.

[26-09-22]

The Judiciary

Title 02
OFFICE OF THE ATTORNEY GENERAL

Subtitle 01 CONSUMER PROTECTION DIVISION

02.01.05 Refund Policy of Retailers

Authority: Commercial Law Article, §§13-205 and 13-303; Annotated Code of Maryland

Notice of Proposed Action

[25-298-P]

The Consumer Protection Division proposes to amend Regulations .02 and .04 under COMAR 02.01.05 Refund Policy of Retailers. This action was considered by the Consumer Protection Division and Consumer Protection Commission at the Commission's November 7, 2025 meeting.

Statement of Purpose

The purpose of this action is to update provisions of the regulation regarding how retailers communicate their refund policies to consumers.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Steven M. Sakamoto-Wengel, Deputy Chief, Consumer Protection Division, 200 St. Paul Place, 16th Floor, Baltimore, MD 21202, or call 410-576-6307, or email to [email protected]. Comments will be accepted through June 12, 2026. A public hearing will be held on June 15, 2026 at 10 a.m. at Consumer Protection Division, 200 St. Paul Place, 16th floor, Baltimore, MD 21202.

.02 Findings and Purpose.

A. Findings. The Division of Consumer Protection of the Office of the Attorney General and the Consumer [Council] Protection Commission find that the refund and exchange policies of merchants, when left unstated, place the consumer at a disadvantage, particularly with merchants who vary refund and exchange policies with different consumers or who change policies without notice. Merchants' failure to communicate policies on refunds and exchanges, be it a policy of no refunds, cash refunds, or credit for returned merchandise, is a practice which is unfair and deceptive.

B. Purpose. The purpose of these regulations is to require that a policy, a change in policy, or special sales promotion policies (such as final sale, fire sale, sale on "as is" merchandise, no returns, etc.), be clearly communicated to the consumer in all retail sales and to declare it to be an unfair, abusive and deceptive practice to fail to communicate the merchants' policies.

.04 Unfair, Abusive, and Deceptive Trade Practices.

A. It shall be an unfair, abusive, or deceptive trade practice prohibited by Commercial Law Article, §13-303, Annotated Code of Maryland, for a merchant in any retail sale to fail to disclose to all customers in writing[,] the terms and conditions of the merchant's refund and exchange policies, or a policy of no refunds or exchanges:

(1) For in-person retail sales either [on the sales form,] by a clearly visible sign, or by a conspicuous label on the consumer goods; and[, the terms and conditions of the merchant's refund and exchange policies, or a policy of no refunds or exchanges.]

(2) For online retail sales, on a webpage the consumer must view before completing the transaction.

B. A merchant shall be deemed in compliance with the requirements of this regulation if the merchant discloses to the customer in writing any time limit on refunds or exchanges and, upon request by the customer or gift recipient, within a reasonable time of the purchase:

[A.](1)—[D.](4) (text unchanged)

STEVEN M. SAKAMOTO-WENGEL
Deputy Chief

02.01.11 Abusive Practices

Authority: Commercial Law Article, §§13-205 and 13-303, Annotated Code of Maryland

Notice of Proposed Action

[25-285-P]

The Consumer Protection Division proposes to adopt new Regulations .01—.03 under a new chapter, COMAR 02.01.11 Abusive Practices. The proposed action was considered at an Open Meeting held pursuant to General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to further define what constitutes an “abusive” practice as set forth in Commercial Law Article, §13-301, Annotated Code of Maryland and prohibited by Commercial Law Article, §13-303, Annotated Code of Maryland. The Consumer Protection Division and the Consumer Protection Commission find that Chapters 731 and 732 of the Acts of 2018 added “abusive” practices to the unfair or deceptive practices prohibited by the Consumer Protection Act. It will further define what constitutes an “abusive” practice as set forth in Commercial Law Article, §13-301, Annotated Code of Maryland, and prohibited by Commercial Law Article, §13-303, Annotated Code of Maryland.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Steven M. Sakamoto-Wengel, Deputy Chief, Consumer Protection Division, 200 St Paul Place, 16th Floor, Baltimore, MD 21202, or call 410-576-6307, or email to [email protected]. Comments will be accepted through June 12, 2026. A public hearing will be held on Monday, June 15, 2026 at 10 am, 200 St. Paul Place, Baltimore, MD 21202.

.01 Authority.

These regulations are promulgated pursuant to Commercial Law Article, §§13-205 and 13-303, Annotated Code of Maryland.

.02 Findings and Purpose.

A. The Consumer Protection Division and the Consumer Protection Commission find that Chapters 731 and 732 of the Acts of 2018 added “abusive” practices to the unfair or deceptive practices prohibited by the Consumer Protection Act.

B. These regulations are intended to further define what constitutes an “abusive” practice as set forth in Commercial Law Article, §13-301, Annotated Code of Maryland and prohibited by Commercial Law Article, §13-303, Annotated Code of Maryland.

.03 Abusive Practices.

“Abusive” practices as set forth in Commercial Law Article, §13-301, Annotated Code of Maryland, and prohibited by Commercial Law Article, §13-303, Annotated Code of Maryland include a practice that:

(1) Materially interferes with the ability of a consumer to understand a term or condition of a consumer product or service; or

(2) Takes unreasonable advantage of:

(a) A lack of understanding on the part of the consumer of the material risks, costs, or conditions of the product or service;

(b) The inability of the consumer to protect the interests of the consumer in selecting or using a consumer product or service; or

(c) The reasonable reliance by the consumer on a person to act in the interests of the consumer.

STEVEN M. SAKAMOTO-WENGEL
Deputy Chief

Title 10
MARYLAND DEPARTMENT OF HEALTH

Subtitle 25 MARYLAND HEALTH CARE COMMISSION

10.25.17 [Benchmarks for] Preauthorization of Health Care Services

Authority: Health-General Article, [§§19-101 and] §§19-103, 19-108.2, 19-108.5, and 19-109, Annotated Code of Maryland

Notice of Proposed Action

[26-050-P]

The Maryland Health Care Commission proposes to amend Regulations .01—.05, adopt new Regulation .06, and amend and recodify existing Regulation .06 to be Regulation .07 under COMAR 10.25.17 Preauthorization of Health Care Services. This action was considered by the Commission at an open meeting held on March 19, 2026, a notice of which was given through publication in the Maryland Register, in accordance with General Provisions Article, §3-302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to propose amendments and a new regulation to COMAR 10.25.17. Legislation passed by the Maryland General Assembly (Chapter 848/Senate Bill 791 and Chapter 847/House Bill 932, Health Insurance—Utilization Review—Revisions, 2024) requires payors to establish and maintain an online process that meets specified parameters by July 1, 2026. The law requires MHCC to establish by regulation a process through which a health care provider may request and receive a waiver of compliance from ensuring that the provider’s e-prescribing or electronic health record system has the ability to access, at the point of prescribing, electronic prior authorization and real-time patient out-of-pocket cost information and available medication alternatives through the payor’s online process. The proposed amendments:

(1) Clarify the scope of the chapter;

(2) Add new definitions and clarify existing definitions for certain terms;

(3) Add a requirement for payors to implement an online process, consistent with State law;

(4) Add a process for providers to request a wavier;

(5) Clarify financial penalties for noncompliance; and

(6) Include other miscellaneous, non-substantive updates.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Justine Springer, Program Manager, Maryland Health Care Commission, 4160 Patterson Avenue Baltimore, MD 21215, or call 410-764-3574, or email to mhcc_regs.comment@maryland.gov. Comments will be accepted through June 1, 2026. A public hearing has not been scheduled.

Open Meeting

Final action on the proposal will be considered by the Maryland Health Care Commission during a public meeting to be held on June 18, 2026, at 1:00 pm, at 4160 Patterson Avenue, Room 100.

.01 Scope.

A. This chapter applies to [a payor that]:

(1) [Requires] A payor that requires preauthorization or step therapy for health care services; and

(2) [Is required to report to the Maryland Health Care Commission on its attainment and plans for attainment of certain preauthorization benchmarks.] A health care provider.

B. (text unchanged)

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) “Carrier” has the meaning stated in Insurance Article, §15-1301, Annotated Code of Maryland.

[(1)] (2)—[(2)] (3) (text unchanged)

(4) “Health care provider” has the meaning stated in Health-General Article, §19-108.3, Annotated Code of Maryland.

[(3)] (5) (text unchanged)

(6) “Online process” means the process established by carriers that meets the requirements outlined in Health-General Article, §19-108.5(b)(1), Annotated Code of Maryland.

[(4)] (7) “Payor” means [one of the following State-regulated entities that require preauthorization for a health care service]:

(a) [An insurer or nonprofit health service plan that provides hospital, medical, or surgical benefits to individuals or groups on an expense-incurred basis under health insurance policies or contracts that are issued or delivered in the State;] A carrier; or

[(b) A health maintenance organization that provides hospital, medical, or surgical benefits to individuals or groups under contracts that are issued or delivered in the State; or]

[c] (b) (text unchanged)

[(5)] (8) “Preauthorization” means the process of obtaining approval for coverage from a payor by meeting certain criteria before a certain health care service [can be] is rendered by the health care provider.

[(6)] (9) “Prescriber” means a health care [practitioner] provider who has the required license and, if necessary, scope of practice or delegation agreement that permits the health care [practitioner] provider to prescribe drugs to treat medical conditions or diseases.

[(7)] (10) “Step therapy or fail-first protocol” is a protocol established by [an insurer, a nonprofit health service plan, a health maintenance organization, or a pharmacy benefits manager] a payor that requires a certain prescription drug or sequence of prescription drugs to be used by an insured individual or an enrollee before another specific prescription drug ordered by a prescriber is covered.

[(8)] (11) “Supporting medical information”—means:

(a)—(b) (text unchanged)

(c) Other information [mutually agreed to] that constitutes sufficient supporting medical information by an insured’s or enrollee’s prescriber and a payor that requires a step therapy or fail-first protocol.

.03 [Benchmarks.] Online Process Requirements.

A. [Each] A payor shall establish and maintain online access for a provider to the following:

(1)—(2) (text unchanged)

B. [Each] A payor shall establish and maintain an online process [for:] that meets the requirements of Health General Article, §§19-108.2 and 19-108.5, Annotated Code of Maryland.

C. A payor’s online process shall:

(1) [Accepting electronically a] Accept electronic preauthorization [request] requests from a health care provider; [and]

(2) [Assigning to a preauthorization request] Assign a unique electronic identification number [that a provider may use to track the request during the preauthorization process, whether the request is tracked electronically, through a call center, or by fax] to each preauthorization request;

(3) Link directly to all e-prescribing systems and electronic health record systems that use the National Council for Prescription Drug Programs SCRIPT standard and the National Council for Prescription Drug Programs Real-Time Benefit Standard;

(4) Provide accurate, real-time patient-specific benefit information to insureds, enrollees, and contracted health care providers, including any:

(a) Copayment, deductible, coinsurance, or other out-of-pocket costs;

(b) More affordable medication alternatives; and

(c) Preauthorization requirements;

(5) Provide the information required under §C(4) of this regulation at the point of prescribing in an accessible and understandable format;

[C. Each payor shall establish and maintain an online preauthorization system that meets the requirements of Health-General Article, §19-108.2(c), Annotated Code of Maryland, to:]

[(1)] (6) Approve in real-time, electronic preauthorization requests [for pharmaceutical services]:

(a) For which no additional information is needed by the payor to process the preauthorization request; [and]

(b) For which no clinical review is required; and

[(2)] (7) Render a determination within 1 business day after receiving all pertinent information on requests not approved in real-time[,] of electronic preauthorization requests for pharmaceutical services that:

(a) (text unchanged)

(b) Do not meet the standards for real-time approval under [§C(1)] §C(6) of this regulation; and

[(3)] (8) Render a determination within 2 business days after receiving all pertinent information[,] of electronic preauthorization requests for health care services, except pharmaceutical services, that are not urgent.

D. [Each] A payor that requires a step therapy or fail-first protocol shall:

(1) Comply with Insurance Article, §15-142(c), Annotated Code of Maryland;

[(1)] (2)—[(3)] (4) (text unchanged)

E. [A payor that becomes authorized to provide benefits or services within the State of Maryland after October 1, 2012, shall meet each benchmark within this chapter within 3 months of the payor’s offering of services or benefits within the State and shall thereafter maintain the processes or actions required by each benchmark.] A payor may not:

(1) Impose a fee or charge a person for accessing its online process; or

(2) Access, without health care provider consent, health care provider data via the online process other than for the insured or enrollee.

.04 Reporting.

[A. A payor that becomes authorized to provide benefits or services within the State of Maryland after October 1, 2012, shall report to the Commission in a form and manner specified by the Commission on its attainment of each benchmark in Regulation .03 of this chapter within 3 months of the payor’s offering of services or benefits within the State.]

[B.] A. If requested by the Commission, a payor shall demonstrate continued compliance with the [benchmarks] preauthorization requirements in Regulation .03 of this chapter.

[C.] B. (text unchanged)

.05 Payor Waiver from [Benchmark] Requirement.

A. A payor may request that the Commission issue or renew a waiver from the requirement to meet a [benchmark] preauthorization requirement in Regulation .03 of this chapter by the demonstration of the following extenuating circumstances:

(1) (text unchanged)

(2) For a group model health maintenance organization, as defined in Health-General Article, §19-713.6, Annotated Code of Maryland, [preauthorizations] preauthorization of health care services requested by providers not employed by the group model health maintenance organization; or

(3) (text unchanged)

B. Submission of Request for Waiver or Renewal of Waiver.

(1) A request for a waiver or renewal of waiver shall be in writing and shall include:

(a) An identification of each preauthorization [benchmark] requirement for which a waiver is requested; and

(b) (text unchanged)

(2) A request for a waiver shall be filed with the Commission in accordance with the following:

(a) (text unchanged)

(b) For a payor that becomes authorized to provide [benefits or] services within the State of Maryland after October 1, 2012, within 3 months after the date the payor is authorized to provide benefits or services within the State.

C. Issuance of Waiver.

(1) The Executive Director may issue a waiver from a preauthorization [benchmark] requirement to a payor that demonstrates extenuating circumstances within this chapter.

(2)—(3) (text unchanged)

D. Withdrawal of Waiver.

(1)—(2) (text unchanged)

(3) After a waiver or a renewal of a waiver is withdrawn, a payor shall submit a plan to the Executive Director within 30 days that includes a timeline for attaining each [benchmark] requirement in Regulation .03 of this chapter in a format approved by the Commission.

E.—F. (text unchanged)

G. A payor that has been granted a waiver under this regulation shall notify the Executive Director if it can no longer demonstrate the extenuating circumstances for which the waiver was granted within 30 days after a payor can no longer demonstrate extenuating circumstances.

.06 Provider Requirements and Waiver.

A. On or before July 1, 2026, a health care provider shall ensure that each e-Prescribing system or electronic health record system owned or contracted for by the health care provider to maintain a health record of an insured or enrollee has the ability to access, at the point of prescribing:

(1) The electronic preauthorization process established by a payor; and

(2) The real-time patient out of pocket cost information and available medication alternatives.

B. Health Care Provider Waiver Requirements.

(1) A health care provider may request that the Commission issue or renew a waiver from the requirements in §A of this regulation by demonstration of the following extenuating circumstances:

(a) Economic hardship;

(b) Technology limitations; or

(c) Other circumstances determined by the Commission to be extenuating.

(2) A health care provider seeking a waiver from the requirements of §A of this regulation shall submit an attestation to the Commission using the form on the Commission’s website.

[.06] .07 Fines.

[A payor that does not meet the reporting requirements of this chapter may be assessed a fine in accordance with COMAR 10.25.12.01, et seq.]

A. A payor that becomes authorized to provide services within the State after the effective date of a requirement in this chapter shall meet each requirement within this chapter within 3 months of offering services.

B. A person that fails to meet a requirement of this chapter may be subject to a financial penalty based on:

(1) The person’s ability to pay;

(2) The willfulness of the improper conduct;

(3) The extent of actual or potential public harm caused by the violation;

(4) The cost of auditing or investigating the matter; and

(5) The person’s history of any previous violation.

C. A person assessed a fine may challenge the assessment in accordance with the procedure outlined in COMAR 10.25.12.02.

MARCIA BOYLE
Acting Chair

Subtitle 27 BOARD OF NURSING

Notice of Proposed Action

[26-045-P]

The Secretary of Health proposes to:

(1) Amend Regulations .02, .05, and .06, and adopt new Regulation .09 under COMAR 10.27.12 Nurse Psychotherapists in Independent Practice—Clinical Nurse Specialists; and (2) Amend Regulations .01, .04, and .06, and adopt new Regulation .07 under COMAR 10.27.27 Practice of Clinical Nurse Specialist.

This action was considered by the public at a public meeting held on January 28, 2026, notice of which was given by publication on the Board’s website at: https://health.maryland.gov/mbon/Pages/meet ings-index.aspx, pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to define “clinical nurse specialist” and “practice as a clinical nurse specialist,” and update scope of practice for the purpose of authorizing clinical nurse specialists to prescribe drugs and durable medical equipment, pursuant to House Bill 278, Health Occupations—Clinical Nurse Specialists—Prescribing, 2023, Ch. 328 and Senate Bill 213, Health Occupations – Clinical Nurse Specialists – Prescribing, 2023, Ch. 327.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jordan Fisher Blotter, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 534 Baltimore, Maryland 21201, or call 410-767-0938, or email to [email protected]. Comments will be accepted through June 1, 2026. A public hearing has not been scheduled.

10.27.12 Nurse Psychotherapists in Independent Practice—Clinical Nurse Specialists

Authority: Health General Article, §4-403; Health Occupations Article, §§8-205 and 8-514; Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(3) (text unchanged)

(4) “Clinical nurse specialist” means an individual who:

(a) Meets one of the following requirements:

(i) Is licensed by the Board to practice registered nursing; or

(ii) Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and

(b) Is certified by the Board to practice as a clinical nurse specialist.

(5) “Durable medical equipment” means equipment that:

(a) Can withstand repeated use;

(b) Is used to serve a medically necessary purpose; and

(c) Has no practical use in the absence of illness, injury, disability, or health condition.

[(4)] (6)—[(6)] (8) (text unchanged)

(9) Practice as a Clinical Nurse Specialist.

(a) “Practice as a clinical nurse specialist” means to:

(i) Provide direct care to patients with complex needs;

(ii) Act as a consultant to another health care provider as needed;

(iii) Conduct health-related research; and

(iv) Provide education and guidance for staff nurses.

(b) “Practice as a clinical nurse specialist” includes:

(i) Ordering, performing, and interpreting laboratory tests;

(ii) Ordering diagnostic tests and using the findings or results in the care of patients;

(iii) Prescribing drugs and durable medical equipment in accordance with Regulation .09 of this chapter;

(iv) Ordering home health and hospice care; and

(v) Initiating, monitoring, and altering appropriate therapies or treatments.

[(7)] (10)—[(9)] (12) (text unchanged)

.05 Scope of Practice.

The PMH/APRN may perform independently, autonomously, and in a variety of settings, the following functions:

A.—G. (text unchanged)

H. Provide behavioral rehabilitation care; [and]

I. Utilize advanced practice skills to independently provide:

(1) Case management including psychiatric rehabilitation and home care[,]; and

(2) Health teaching, health promotion, health prevention, and aid to the client in developing healthy patterns of living[.]; and

J. Prescribe drugs and durable medical equipment in accordance with Regulation .09 of this chapter.

.06 Standards of Practice.

A.—E. (text unchanged)

[F. The use of psycholobiological interventions in this chapter does not authorize the prescription of medications.]

[G.]F—[I.]H. (text unchanged)

I. Medical records shall be maintained in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.

.09 Prescriptive Authority.

A. A clinical nurse specialist may prescribe any drug or durable medical equipment within the clinical nurse specialist’s education, training, certification, and population foci.

B. A clinical nurse specialist when exercising prescriptive authority is accountable for competency in:

(1) Problem identification through appropriate assessment;

(2) Medication and device selection;

(3) Patient education for use of therapeutics;

(4) Knowledge of interactions of therapeutics;

(5) Evaluation of outcome; and

(6) Recognition and management of side effects, adverse reactions, and complications.

10.27.27 Practice of Clinical Nurse Specialist

Authority: Health General Article, §4-403; Health Occupations Article, §§8-205(a)(1), (2), (4), and (5), [and 8-302(b)(1)(iii) and (2)(ii)] 8-302, and 8-514; Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(3) (text unchanged)

(4) “Clinical nurse specialist” means an [advanced practice registered nurse certified by the Board to practice as a clinical nurse specialist in this State.] individual who:

(a) Meets one of the following requirements:

(i) Is licensed by the Board to practice registered nursing; or

(ii) Has a multistate licensure privilege to practice registered nursing under the Nurse Licensure Compact; and

(b) Is certified by the Board to practice as a clinical nurse specialist.

(5) “Durable medical equipment” means equipment that:

(a) Can withstand repeated use;

(b) Is used to serve a medically necessary purpose; and

(c) Has no practical use in the absence of illness, injury, disability, or health condition.

[(5)] (6) (text unchanged)

(7) Practice as a Clinical Nurse Specialist.

(a) “Practice as a clinical nurse specialist” means to:

(i) Provide direct care to patients with complex needs;

(ii) Act as a consultant to another health care provider as needed;

(iii) Conduct health-related research; and

(iv) Provide education and guidance for staff nurses.

(b) “Practice as a clinical nurse specialist” includes:

(i) Ordering, performing, and interpreting laboratory tests;

(ii) Ordering diagnostic tests and using the findings or results in the care of patients;

(iii) Prescribing drugs and durable medical equipment in accordance with Regulation .07 of this chapter;

(iv) Ordering home health and hospice care; and

(v) Initiating, monitoring, and altering appropriate therapies or treatments.

[(6)] (8)—[(8)] (10) (text unchanged)

.04 Scope and Standards of Practice.

A. (text unchanged)

B. The clinical nurse specialist:

(1) [provides] Provides direct care to patients with complex needs[,];

(2) [acts] Acts as a consultant[,];

(3) Leads evidence-based practice;

(4) [conducts] Conducts research[,];

(5) Optimizes organizational systems;

(6) Advances nursing practice; and

(7) [provides] Provides education and guidance for staff nurses.

C.—D. (text unchanged)

E. The scope of practice of the clinical nurse specialist includes, but is not limited to:

(1)—(2) (text unchanged)

(3) Establishing medical diagnosis for [common] short-term and chronic stable health problems;

(4)—(10) (text unchanged)

(11) Consulting or collaborating with a licensed physician or other health care provider as needed; [and]

(12) Creating therapeutic environments through mentoring and system changes to:

(a)—(c) (text unchanged)

(d) Alleviate patient distress[.]; and

(13) Prescribing drugs and durable medical equipment in accordance with Regulation .07 of this chapter.

F. The clinical nurse specialist shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.

.06 Unlawful Practices.

[A. Unless authorized to practice under this chapter, an individual may not use the following words or abbreviations:

(1) Certified clinical nurse specialist;

(2) Clinical nurse specialist (CNS);

(3) Clinical Registered Nurse Specialist (CRNS);

(4) Clinical nurse specialist graduate; or

(5) Nurse specialist graduate.]

A. Unless certified as a clinical nurse specialist under this chapter, an individual may not:

(1) Practice as a clinical nurse specialist;

(2) Represent to the public by title, description of services, method, procedure, or otherwise that the individual is authorized to practice as a clinical nurse specialist; or

(3) Use the following words or abbreviations:

(a) Certified clinical nurse specialist;

(b) Clinical nurse specialist (CNS);

(c) Clinical Registered Nurse Specialist (CRNS);

(d) Clinical nurse specialist graduate; or

(e) Nurse specialist graduate.

B. (text unchanged)

.07 Prescriptive Authority.

A. A clinical nurse specialist may prescribe any drug or durable medical equipment within the clinical nurse specialist’s education, training, certification, and population foci.

B. A clinical nurse specialist, when exercising prescriptive authority, is accountable for competency in:

(1) Problem identification through appropriate assessment;

(2) Medication and device selection;

(3) Patient education for use of therapeutics;

(4) Knowledge of interactions of therapeutics;

(5) Evaluation of outcome; and

(6) Recognition and management of side effects, adverse reactions, and complications.

MEENA SESHAMANI, MD, PHD
Secretary of Health

Subtitle 41 BOARD OF EXAMINERS FOR AUDIOLOGISTS, HEARING AID DISPENSERS, SPEECH-LANGUAGE PATHOLOGISTS, AND MUSIC THERAPISTS

Notice of Proposed Action

[26-044-P]

The Secretary of Health proposes to:

(1) Amend Regulations .02 and .04 under COMAR 10.41.02 Code of Ethics;

(2) Amend Regulations .02, .03, and .06 under COMAR 10.41.03 Licensure and Continuing Education;

(3) Amend Regulations .02, .04, and .05, adopt new Regulation .06, and recodify existing Regulations .06 and .07 to be Regulations .07 and .08, respectively, under COMAR 10.41.05 Music Therapy;

(4) Amend Regulations .02—.04 and repeal existing Regulation .05 under COMAR 10.41.07 Cerumen Management;

(5) Amend and recodify existing Regulations .01-1, .03, .06, .08, .10, and .14 to be Regulations .02, .05, .08, .09, .11, and .15, respectively, adopt new Regulation .03, and recodify existing Regulations .02, .04, .05, .09, .11, .12, and .13 to be Regulations .04, .06, .07, .10, .12, .13, and .14, respectively, under COMAR 10.41.08 Hearing Aid Dispensing;

(6) Amend Regulations .01, .06, .07, .09, .10, and .13 under COMAR 10.41.11 Speech-Language Pathology Assistants and Audiology Assistants; and

(7) Amend Regulations .03 and .04 under COMAR 10.41.12 Supervision of Students.

This action was considered by the Board of Examiners for Audiologists, Hearing Aid Dispensers, Speech-Language Pathologists, and Music Therapists at a public meeting held on January 15, 2026, notice of which was given by publication on the Board’s website at health.maryland.gov/boardsahs/Pages/Index.aspx pursuant to General Provisions Article, §3–302(c), Annotated Code of Maryland.

Statement of Purpose

The purpose of this action is to:

(1) Update ethical responsibilities;

(2) Update and clarify licensure and continuing education requirements;

(3) Revise and update certain definitions;

(4) Add scope of practice for hearing aid dispensers;

(5) Update the sale of hearing aid software guidelines to be consistent with Maryland law; and

(6) Remove obsolete language.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Jordan Fisher Blotter, Director, Office of Regulation and Policy Coordination, Maryland Department of Health, 201 West Preston Street, Room 534, Baltimore, Maryland 21201, or call 410-767-0938, or email to [email protected]. Comments will be accepted through June 1, 2026. A public hearing has not been scheduled.

10.41.02 Code of Ethics

Authority: Health Occupations Article, §§1-212, 2-205 and 2-314, Annotated Code of Maryland

.02 Ethical Responsibilities.

A.—B. (text unchanged)

C. Professional Conduct.

(1)—(7) (text unchanged)

(8) Licensees may not engage in self-referral as set forth in 42 U.S.C. §1395nn and Health Occupations Article, §1-302, Annotated Code of Maryland.

D.—G. (text unchanged)

.04 Special Responsibilities.

A.—G. (text unchanged)

H. The licensee shall:

(1) Maintain adequate records of professional services rendered and products dispensed, including:

(a)—(b) (text unchanged)

(d) For audiograms, the following information:

(i) The licensee’s signature;

(ii) Audiometer used;

(iii) Calibration date;

(iv) License number; and

(v) The applicable American National Standards Institute (ANSI) standard;

[(d)] (e) (text unchanged)

[(e)] (f) All documents related to referrals or orders; and

(2) (text unchanged)

I.—L. (text unchanged)

10.41.03 Licensure and Continuing Education

Authority: Health Occupations Article, §§2-205, 2-302, 2-302.2, 2-304, 2-305, 2-308, 2-310, 2-310.2, [2-311(c)] 2-311(d), 2-312(b), 2-314(11), and 2-314.9, Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(2) (text unchanged)

[(3) “Credit” means 1 semester hour except when specified in these regulations. “Credit” is used only with reference to fulfilling academic requirements for original licensure application.]

[(4)] (3) (text unchanged)

(4) Credit.

(a) “Credit” means 1 semester hour except when otherwise specified in these regulations.

(b) “Credit” is used only with reference to fulfilling academic requirements for original licensure application.

(5) (text unchanged)

(6) “Health screening” means a non-diagnostic assessment on an individual to check for a health condition before there are signs and symptoms.

[(6)] (7)—[(7)] (8) (text unchanged)

.03 Licensure Requirements.

A. (text unchanged)

B. Supervision of Professional Experience for Audiologists.

(1) Supervisory Plan for Audiologists.

(a)—(b) (text unchanged)

[(c) The Board may accept completion of the clinical fellowship required for the American Speech-Language-Hearing Association Certificate of Clinical Competence or completion of the mentored practice required for American Board of Audiology Certification as meeting the requirements for supervised practice in this chapter.]

(2) (text unchanged)

(3) To complete a clinical training, the applicant shall [be employed as a professional] gain professional experience in the field of audiology under appropriate on-site direct supervision for not less than [9] 12 months with a minimum of 36 hours of work per week. This requirement may also be met with part-time employment as follows:

(a) [14—16] 16 hours a week for a period of [24] 27 months;

(b) [17—20] 24 hours a week for a period of 18 months; or

[(d) 25—35 hours a week for a period of 12 months.]

(4) At least 80 percent of the applicant's [employment] professional experience during the clinical training shall be in direct client contact which includes:

(a)—(b) (text unchanged)

(i)—(iii) (text unchanged)

(d) (text unchanged)

(5) An individual serving as a supervisor:

(a)—(b) (text unchanged)

(d) (text unchanged)

(6) (text unchanged)

(7) Change in Supervisor or [Place of] Professional [Employment] Experience Training Site.

(a) During the period of limited licensure, if an individual changes supervisor, or [place of] professional [employment] experience training site, or both, the individual shall submit a revised supervisory plan to the Board for Board approval.

(b) (text unchanged)

(8) (text unchanged)

C. Supervision of Clinical Fellowship for Speech Pathologists.

(1)—(2) (text unchanged)

(3) To complete a clinical fellowship, the applicant shall [be employed as a professional] gain professional experience in the field of speech-language pathology under appropriate supervision for not less than 9 months with a minimum of 30 hours of work per week. This requirement may also be met with part-time employment as follows:

(a)—(c) (text unchanged)

(4) At least 80 percent of the applicant's [employment] professional experience during the clinical fellowship shall be in direct client contact, which includes:

(a)—(d) (text unchanged)

(5)—(6) (text unchanged)

(7) Change in Supervisor or [Place of] Professional [Employment] Experience Training Site.

(b) (text unchanged)

(8) (text unchanged)

D. (text unchanged)

.06 Continuing Education Requirements.

A. Required Continuing Education Units.

(1) Within the 2-year renewal period immediately preceding the licensee's application for renewal, the licensee shall earn 30 continuing education units (CEUs) as follows:

(a)—(b) (text unchanged)

(i) Job orientation; or

(ii) Job maintenance[; or].

[(iii) Other general training or information related to human health.]

(2)—(5) (text unchanged)

B.—H. (text unchanged)

10.41.05 Music Therapy

Authority: Health Occupations Article, §§2-101, 2-201, 2-202(a), 2-206(a) and (d)(2), 2-501, and 2-4A-01—2-4A-25, Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(2) (text unchanged)

(3) “Continuing Music Therapy Education (CMTE)” means continuing music therapy education that is 50 minutes in duration and is equivalent to 1 continuing education hour.

(4) “Health screening” means a non-diagnostic assessment on an individual to check for a health condition before there are signs and symptoms.

[(3)] (5)—[(5)] (7) (text unchanged)

.04 Renewal of Licensure.

A.—B. (text unchanged)

C. At least [1 month] 60 days before a license expires, the Board shall send to the licensee, by first-class mail or email to the last known address of the licensee, a renewal notice that states the:

(1)—(3) (text unchanged)

D.—E. (text unchanged)

.05 Continuing Education Requirements.

A. The continuing education requirements shall include proof of completion of at least 40 [hours] CMTEs of continuing education in a program approved by CBMT or any successor organization approved by the Board that includes:

(1) A minimum of 1 [CEU] CMTE in the area of cultural competency;

(2) A minimum of 1 [CEU] CMTE in the area of ethics;

(3) [Supervision] A minimum of 2 CMTEs in the area of supervision; and

[(4) Billing;

(5) Interdisciplinary collaboration; and]

[(6)] (4) Related training that does not include annual training requirements for:

(a) Job orientation; or

(b) Job maintenance[; or].

[(c) Other general training or information related to human health.]

[B. It is recommended that a licensee applying for the renewal of a license successfully complete, within the 2-year licensing period as a part of the required 40 hours of Board-approved continuing education programs, a minimum of 2 CEUs in the area of supervision.]

[C.] B. (text unchanged)

.06 Continuing Education Audit Procedures.

A. At each renewal period, the Board shall audit 10 percent of the renewal applications received for the renewal period.

B. The two Board members who are licensed professional music therapists shall be audited for the required CMTEs.

C. The Board shall send notification of audit to licensees subject to audit.

D. The licensee being audited shall submit to the Board official certificates or transcripts via mail or by electronic means showing evidence of the continuing education required for renewal by the date indicated on the audit notification.

E. The Board may take formal disciplinary action against the licensee in accordance with COMAR 10.41.13, if the licensee:

(1) Submits a false statement of continuing education; or

(2) Fails to submit the required documents by the date indicated on an audit notification.

10.41.07 Cerumen Management

Authority: Health Occupations Article, §§2-101(n) and [2-205(a)(1)] 2-205(1), Annotated Code of Maryland

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

[(2) "Medical liaison" means a cooperative arrangement for consultation with a physician, preferably an otolaryngologist.]

(2) “Foreign body” means any object or substance that enters the ear from the outside.

(3) (text unchanged)

.03 Limitations.

[A. Before the removal of cerumen, the licensee shall obtain the informed consent of the patient, or legally responsible adult, and maintain documentation.]

[B.] A. (text unchanged)

B. Cerumen removal may not be performed if anesthesia is required to complete the procedure.

.04 Training, Knowledge, and Skills.

[A.] [The] As documented in accredited audiology program standards, the licensee shall be responsible for obtaining the training, knowledge, and skills necessary to [perform] remove [cerumen management]:

A. Cerumen; or

B. A foreign body from the external auditory canal that is not impacted to the point that anesthesia is required.

[B. Failure to obtain the training before performing cerumen management may subject the licensee to disciplinary action.

C. The licensee shall obtain training that includes:

(1) Principles of cerumen management including the anatomy of the ear canal and the ear drum and classification of cerumen;

(2) Use of instruments;

(3) Techniques for cerumen removal;

(4) Recognition of complications;

(5) Recognition of contraindications including but not limited to:

(a) Only hearing ear;

(b) Perforated tympanic membrane;

(d) Ear surgery within the past 6 months or tympanostomy tubes;

(e) Diabetes mellitus, HIV infection, bleeding disorder, or other medical contraindications;

(f) Actual or suspected foreign body;

(g) Stenosis or bony exostosis of the ear canal;

(h) Dizziness occurring during cerumen removal;

(i) Cerumen impaction that totally occludes the ear canal; and

(6) Clinical experience gained under the direct supervision of a qualified professional.

D. The licensee shall maintain documentation evidencing the satisfactory completion of the required training.]

10.41.08 Hearing Aid Dispensing

Authority: Health Occupations Article, §§2-101(d), 2-205, 2-302.1, 2-304, 2-308, 2-310.1, 2-311(c), 2-311—2-314.8, 2-314(10) and (11), and 2-314.9, Annotated Code of Maryland

[.01-1] .02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1) (text unchanged)

(2) “Health screening” means a non-diagnostic assessment on an individual to check for a health condition before there are signs and symptoms.

(3) “Hearing aid dome” means a small silicone or plastic tip that fits over the speaker (receiver) of a Receiver-in Canal (RIC) hearing aid.

(4) “Locked hearing aid” means a hearing aid that restricts a licensed hearing aid dispenser from using locked, proprietary software, proprietary programing software, or unlocked programming software to program, fit, or modify the hearing aid.

[(2)] (5)—[(4)] (7) (text unchanged)

.03 Scope of Practice.

A. A licensed hearing aid dispenser may not perform any of the following:

(1) For pediatric patients:

(a) Testing;

(b) Ordering, selling, dispensing, or fitting a prescription hearing aid; or

(c) Programming, modifying, or repairing a hearing aid;

(2) Tinnitus testing, evaluations, counseling, management, device fitting, troubleshooting, programming verification or follow-up;

(3) Immittance testing to include tympanometry, acoustic reflexes, acoustic delay, or eustachian tube dysfunction testing;

(4) Cochlear implant evaluation, counseling, device selection, activation, programming, reprogramming, verification, or testing;

(5) The removal of cerumen from the external auditory canal; or

(6) The removal of a foreign body from the external auditory canal.

B. A licensed hearing aid dispenser may remove a hearing aid dome, except for the following clients:

(1) If the client is diabetic;

(2) If the client is on over-the-counter blood thinners;

(3) If the client’s hearing aid dome is beyond the second bend in the auditory canal;

(4) If the client has a bleeding disorder;

(5) If the client has a tympanic membrane perforation;

(6) If the client has HIV/AIDS; or

(7) If the client has a surgically altered ear.

[.03] .05 Examinations—General.

A. (text unchanged)

B. Except for an applicant who holds a valid license to provide hearing aid dispenser services in another state or an applicant who holds a valid license to practice medicine in this State or any other state, the applicant shall obtain 6 months training under the supervision of a licensed hearing aid dispenser or licensed audiologist before taking the examination given by the Board.

C. The Board shall:

(1) (text unchanged)

(2) Request that an applicant, who holds a valid license to practice medicine in this State or any other state and intends to sell hearing aids at retail, [take] pass the practical examination given by the Board to ensure adequate protection to the consumer.

D. (text unchanged)

E. Before taking the Hearing Aid Dispensing Examination, a candidate shall provide the Board with [a certificate of completion of the International Hearing Society course entitled "Distance Learning for the Professional in Hearing Health Sciences"] documentation of completion of a nationally recognized, comprehensive hearing aid dispensing training course approved by the Board.

[.06] .08 Practice of Limited Licensee.

A.—B. (text unchanged)

C. The supervising hearing aid dispenser or audiologist shall be immediately available and physically on-site.

D. Supervision shall include training in those areas of the examination outlined in [Regulation .05] Regulation .07 of this chapter.

E.—J. (text unchanged)

K. The supervisor of a limited licensee:

(1) (text unchanged)

(2) Shall conduct all required direct and continuous supervision as defined in §B of this regulation, at a Maryland [hearing aid dispensing] practice [only] which dispenses hearing aids;

(3)—(6) (text unchanged)

[.08] .09 Testing Procedures.

A. The licensee or holder of a limited license who is engaged in the fitting and dispensing of hearing aids shall use appropriate non-diagnostic testing procedures for a hearing aid fitting.

B. The licensee or holder of a limited license shall perform the following minimum testing procedures on each client evaluated prior to the fitting of a hearing aid or hearing aids:

(1)—(2) (text unchanged)

(3) Word recognition scores obtained using recorded [word lists] stimuli or monitored live voice.

(4) Presentation level shall be at least [40dB] 40dBHL above speech recognition threshold or [at least 5dB above the threshold at 2000Hz, or both, if within level of tolerance] uncomfortable listening levels (UCL) minus 5dBHL.

C. (text unchanged)

D. The use of probe microphone measurements are recommended to verify the audibility of speech at [50dB] 50dBSPL, [65dB] 65dBSPL, and [80dB] 80dBSPL input levels as well as MPO measurements to avoid damage to the peripheral auditory system and check comfort of the hearing aid users.

E. The hearing aid dispenser shall:

(1) Maintain and retain all test results as part of a client’s record. Part or all of the tests may be performed by [an otologist or] a clinical audiologist, but the test may not be more than 6 months old for the use of a hearing device fitting; and

(2) (text unchanged)

F. (text unchanged)

G. Before fitting or selling a hearing aid to a potential client, the licensee shall refer the client to a physician, preferably one specializing in the diseases of the ear, if the licensee determines that the client has any of the following [conditions] Food and Drug Administration’s (FDA) red flag warnings:

(1)—(9) (text unchanged)

[.10] .11 Disclosure.

A. A licensee shall deliver to an individual supplied with a hearing aid[,] a receipt, that complies with the State Hearing Aid Sales Act in accordance with Commercial Law Article, §14-2503, Annotated Code of Maryland, and Health Occupations Article, §2-314.8, Annotated Code of Maryland, containing:

(1)—(4) (text unchanged)

(5) Date of the consummation of the sale;

[(5)] (6) [Other terms of the sale, stated clearly] The terms of any guarantee or written warranty, as required by federal law or regulations, made to the purchaser with respect to the hearing aid; and

[(6)] (7) (text unchanged)

B. (text unchanged)

[.14] .15 Sale of Hearing Aid Software Guidelines.

A. To the extent not inconsistent with federal law, a licensee shall, before the consummation of a sale of a hearing aid that uses proprietary programming software or locked, [nonproprietary] proprietary hearing aid programming software, provide the purchaser with a written notice that:

(1) States, “The hearing aid being purchased uses proprietary hearing aid programming software or locked, proprietary hearing aid programming software and can only be serviced or programmed at specific facilities or locations that the hearing aid distributor or manufacturer allows to use the proprietary hearing aid programming software or locked programming hearing aid software.”;

(2)—(3) (text unchanged)

B. To the extent not inconsistent with federal law, a licensee shall, before the consummation of a sale of a locked hearing aid, provide the purchaser with a written notice that:

(1) States, “The hearing aid being purchased is “locked” and can only be serviced or programmed at specific facilities or locations that the hearing aid distributor or manufacturer permits to service, modify, or program a locked hearing aid.”;

(2) Shall be signed by the purchaser before the sale; and

(3) Includes a copy that is kept and maintained by the licensee.

[B.] C. (text unchanged)

D. A licensee shall meet any additional requirements set forth under Commercial Law Article, §§14-2501—14-2506, Annotated Code of Maryland.

10.41.11 Speech-Language Pathology Assistants and Audiology Assistants

Authority: Health Occupations Article, §§2-101, 2-102, 2-205, 2-308, 2-311(c), 2-312(b), 2-314, 2-319, [2-3A 01—2-3A-07] 2-3B 01—2-3B-07, 2-401, 2-402.4, and 2-406, Annotated Code of Maryland

.01 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(4) (text unchanged)

(5) “Delegation agreement” means an agreement between: [a speech-language pathology assistant or an audiology assistant and a supervising speech-language pathologist or audiologist which identifies the supervising speech-language pathologist or audiologist and the facility at which the speech-language pathology assistant or the audiology assistant will be practicing.]

(a) A speech-language pathology assistant and a supervising speech-language pathologist which identifies the supervising speech-language pathologist and the facility at which the speech-language pathology assistant will be practicing; or

(b) An audiology assistant and a supervising audiologist which identifies the supervising audiologist and the facility at which the audiology assistant will be practicing.

(6) Direct supervision.

(a) (text unchanged)

(b) “Direct Supervision” includes:

(i) [the] The supervising audiologist viewing and communicating with the [speech-language pathology assistant or] audiology assistant via telecommunication technology to provide clinical services[.]; or

(ii) The supervising speech-language pathologist viewing and communicating with the speech-language pathology assistant via telecommunication technology to provide clinical services.

(7) “General supervision” means the supervision of a licensed:

(a) [speech-language pathology assistant or audiology] Audiology assistant by a licensed [speech-language pathologist or] audiologist who may or may not be present when the licensed [speech-language pathology assistant or] audiology assistant assists in the practice of [speech-language pathology or] audiology[.]; or

(b) Speech-language pathology assistant by a licensed speech-language pathologist who may or may not be present when the licensed speech-language pathology assistant assists in the practice of speech-language pathology.

(8) (text unchanged)

(9) “Professional development hour (PDH)” means 1 contact hour of instruction, presentation, or study.

[(9)] (10)—[(11)] (12) (text unchanged)

.06 Speech-Language Pathology Assistant or Audiology Assistant Scope of Practice.

A.—B. (text unchanged)

C. Activities within the scope of practice of a speech-language pathology assistant [or an audiology assistant] may include the following:

(1)—(4) (text unchanged)

(5) Participating with the supervising speech-language pathologist [or audiologist] in research projects, in-service training, and public relations programs; and

(6) Assisting the speech-language pathologists [or audiologists] during patient assessments[; and

(7) Assisting the audiologists with basic diagnostic tests, such as audiometry and tympanometry].

D. Activities not within the scope of practice of a speech-language pathology assistant or an audiology assistant include:

(1) [Performing or interpreting] Interpreting the results of [diagnostic evaluations] testing;

(2)—(8) (text unchanged)

E. (text unchanged)

.07 Supervisor Responsibilities.

A. A supervising:

(1) [speech-language] Speech-language pathologist [or audiologist] is responsible for the direction of all client services provided by a speech-language pathology assistant [or an audiology assistant.]; or

(2) Audiologist is responsible for the direction of all client services provided by an audiology assistant.

B. A licensed full-time (35 hours or more a week):

(1) [speech-language] Speech-language pathologist [or audiologist] may not supervise more than the equivalent of two full-time (35 hours or more a week) speech-language pathology assistants [or audiology assistants.]; or

(2) Audiologist may not supervise more than the equivalent of two full-time (35 hours or more a week) audiology assistants.

C. A licensed part-time (less than 35 hours a week):

(1) [speech-language] Speech-language pathologist [or audiologist] may not supervise more than the equivalent of one full-time (35 hours a week) speech-language pathology [assistant or audiology assistant.] assistant; or

(2) Audiologist may not supervise more than the equivalent of two full-time (35 hours a week) audiology assistants.

D. A supervising speech-language pathologist or audiologist shall:

(1) (text unchanged)

(2) Maintain on-going contact with all clients seen by a speech-language pathology assistant [or an audiology assistant] by participating in:

(a)—(b) (text unchanged)

(3)—(9) (text unchanged)

.09 License Renewal.

A.—B. (text unchanged)

C. At least [1 month] 60 days before the license expires, the Board shall notify the speech-language pathology assistant or the audiology assistant of the date the license expires and the procedures for renewing the license.

D.—F. (text unchanged)

G. A licensee who has failed to renew a license to practice in this State by June [30] 1 of the year in which the license is due to be renewed is prohibited from practicing in this State.

H. (text unchanged)

.10 Continuing Education Requirements.

A. A speech-language pathology assistant [or an audiology assistant] shall obtain CEUs as a means of staying current in the field.

B. The speech-language pathology assistant [or the audiology assistant] shall earn a minimum of ten CEUs as a condition of renewal as follows:

(1) (text unchanged)

(2) Five CEUs in work-related areas that may include the recommended completion of:

(a)—(b) (text unchanged)

(i) Job orientation; or

(ii) Job maintenance[; or

(iii) Other general information related to health care].

C. An audiology assistant shall obtain PDHs as a means of staying current in the field.

D. The audiology assistant shall earn a minimum of ten PDHs as a condition of renewal as follows:

(1) Five PDHs in the area of clinical practice; and

(2) Five PDHs in work-related areas that may include the recommended completion of:

(a) A minimum of 1 CEU in the area of cultural competency;

(b) A minimum of 1 CEU in the area of ethics; and

(c) Related training that does not include annual training requirements for:

(i) Job orientation; or

(ii) Job maintenance.

[C.] E. The speech-language pathology assistant or the audiology assistant shall retain records documenting completion of CEUs or PDHs.

[D.] F. (text unchanged)

[E.] G. If the speech-language pathology assistant or the audiology assistant is audited by the Board, the speech-language pathology assistant or the audiology assistant shall submit to the Board the following:

(1)—(2) (text unchanged)

(3) Documentation of earned CEUs or PDHs completed within the 2 years immediately preceding the license expiration date.

10.41.12 Supervision of Students

Authority: Health Occupations Article, §§2-205 and 2-302, Annotated Code of Maryland

.03 Supervision.

A.—E. (text unchanged)

F. The licensed audiologist or speech-language pathologist acting as a supervisor shall have 3 years post-degree clinical experience[, including clinical fellowship].

.04 Exceptions.

A. An audiology student who is enrolled full-time [as a 4^th] in the final year as a doctoral student at a university and has completed 375 clinical training hours with 100 percent direct on-site supervision may utilize the following schedule as a minimum for supervision:

(1) For 3 months or the first 1/3 of the [4^th] final year of clinical work, whichever is longer – 90 percent on-site supervision;

(2) For 3 months or the second 1/3 of the [4^th] final year of clinical work, whichever is longer – 75 percent on-site supervision; and

(3) For 3 months or the last 1/3 of the [4^th] final year of clinical work, whichever is longer –50 percent on-site supervision.

B. (text unchanged)

C. An audiology student who is enrolled full-time [as a fourth] in the final year as a doctoral student at a university and holds a hearing aid dispenser license shall follow the requirements of §A of this regulation while working toward the degree.

MEENA SESHAMANI, MD, PHD
Secretary of Health

Subtitle 67 MARYLAND HEALTHCHOICE PROGRAM

Notice of Proposed Action

[26-046-P]

The Secretary of Health proposes to amend:

(1) Regulation .08 under COMAR 10.67.03 Maryland Medicaid Managed Care Program: MCO Application;

(2) Regulations .02, .03-2, and .20 under COMAR 10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations;

(3) Regulations .07 and .28 under COMAR 10.67.06 Maryland Medicaid Managed Care Program: Benefits; and

(4) Regulations .02 and .04 under COMAR 10.67.09 Maryland Medicaid Managed Care Program: MCO Dispute Resolution Procedures.

Statement of Purpose

The purpose of this action is to:

(1) Clarify managed care organization requirements to maintain health plan and health outcomes accreditation;

(2) Update enrollee identification and pharmacy card requirements to align with federal regulation;

(3) Specify requirements regarding incentive plan disclosures;

(4) Update performance measures for the Population Health Incentive Program for measurement year 2026;

(5) Clarify coverage for newborns during hospitalizations of birthing parents after labor without requiring enrollee notification of the MCO;

(6) Extend self-referral for doula services through December 31, 2026;

(7) Establish clearer timelines for written grievance acknowledgements; and

(8) Change the standard preauthorization timeframe from 14 days to 7 days.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

10.67.03 Maryland Medicaid Managed Care Program: MCO Application

Authority: Health-General Article §§15-102 and 15-103, Annotated Code of Maryland

.08 National Committee on Quality Assurance (NCQA) Accreditation.

A.—B. (text unchanged)

C. An MCO shall maintain health plan accreditation and health outcomes accreditation to participate in the HealthChoice program.

D. An MCO with a suspended or terminated accreditation status shall be subject to sanctions in accordance with COMAR 10.67.10.01.

10.67.04 Maryland Medicaid Managed Care Program: Managed Care Organizations

Authority: Health-General Article, §§2-104, 15-101, 15-102.3, and 15-103; Insurance Article, §§15-112, 15-605, and 15-1008; Annotated Code of Maryland

.02 Conditions for Participation

A.—B. (text unchanged)

C. An MCO shall enter a memorandum of understanding with each local health department [(LHD)] in its service area addressing the method by which the MCO and the [LHD] local health department will collaborate and communicate on matters of mutual interest and concern, including but not limited to the responsibility of the [LHD] local health department for:

(1) [contact] Contact tracing for sexually transmitted diseases; and

(2) [directly] Directly observed therapy for tuberculosis.

D. (text unchanged)

E. Health Care Delivery. An MCO shall:

(1)—(2) (text unchanged)

(3) Provide each enrollee within 10 days of notification to the MCO of the [enrollees] enrollee’s enrollment with a distinctive, durable identification card, clearly indicating the bearer to be a member of the MCO and containing, at a minimum:

(a)—(b) (text unchanged)

(d) Enrollee's assigned primary care provider's name and telephone number; and

(e) The Department’s name, logo, or other Department branding as approved by the Department;

(4) (text unchanged)

(5) Provide on the card required in §E(3) of this regulation, on a separate prescription benefit card, or other technology, prescription billing information that:

(a) (text unchanged)

(b) Includes, at a minimum, the following data elements:

(i)—(ii) (text unchanged)

(iii) The telephone number that providers may call for pharmacy benefit assistance; [and]

(iv) The unique Medicaid-specific Bank Identification Number and Processor Control Number combination, along with group number identifiers, necessary for the participant to obtain pharmacy benefits; and

[(iv)] (v) All additional electronic transaction routing information and other numbers required by the MCO or its [benefit administrator] pharmacy benefits manager to process a prescription claim electronically.

F.—M. (text unchanged)

N. Disclosure of Provider Incentive Plans.

(1) An MCO shall [disclose to the Department the information on its provider incentive plans listed in 42 CFR §417.479(h)(1):] include, at a minimum, the provisions required by 42 CFR §438.3(i)(3) in all provider incentive plans.

(2) An MCO shall disclose the provisions detailed in §N(1) of this regulation:

(a)—(b) (text unchanged)

[(2)] (3) An MCO shall include in the disclosures required by [§N(1)] §N(2) of this regulation information sufficient for the Department to determine whether the incentive plans meet the requirements of [42 CFR §417.479(d)(g)] 42 CFR §438.3(i)(3) [and, as applicable (i),] when there exist compensation arrangements under which payment for designated health services furnished to an individual on the basis of a physician referral would otherwise be denied under §1903(a) of the Social Security Act.

O.—R. (text unchanged)

.03-2 HealthChoice Population Health Incentive Program (PHIP).

A. (text unchanged)

B. An MCO may be eligible for an incentive payment for the following measures through measurement year 2025:

(1)—(8) (text unchanged)

C. Effective measurement year 2026, an MCO may be eligible for an incentive payment for the following measures:

(1) Child and adolescent well-care visits—total rate indicator;

(2) Childhood immunization status—combination 3 indicator;

(3) Colorectal cancer screening—total rate indicator;

(4) Controlling high blood pressure;

(5) Glycemic status assessment for patients with diabetes—Glycemic status >=9.0 percent indicator;

(6) Immunizations for adolescents—combination 2 indicator;

(7) Prenatal and postpartum care—timeliness of prenatal care indicator;

(8) Well-child visits in the first 30 months of life—ages 0-15 months indicator; and

(9) Well-child visits in the first 30 months of life—ages 15-30 months indicator.

[C.] D.—[H.] I. (text unchanged)

[I.] J. Round One Incentives.

(1)—(2) (text unchanged)

(3) Performance Incentive Payments for Round One.

(a) Performance incentive payments shall be based on the following categories for each performance measure:

(i) Superlative performance, meaning the performance measure’s score is at or above the 90^th percentile of HEDIS Medicaid performance nationwide during the prior measurement year, or estimated 90^th percentile among Maryland HealthChoice MCO performance for non-HEDIS performance measures;

(ii) Very strong performance, meaning the performance measure’s score is between the 75^th and 89^th percentiles, inclusive, of HEDIS Medicaid performance nationwide during the prior measurement years, or between the estimated 75^th and 89^th percentiles, inclusive, among Maryland HealthChoice MCO performance for non-HEDIS performance measures; or

(iii) Strong performance, meaning the performance measure’s score is between the 50^th and 74^th percentiles, inclusive, of HEDIS Medicaid performance nationwide during the prior measurement year, or between the estimated 50^th and 74^th percentiles, inclusive, among Maryland HealthChoice MCO performance for non-HEDIS performance measures.

(b) Payments for round one performance incentives shall be allocated as follows:

(i)—(iii) (text unchanged)

(iv) Any MCO earning a performance measure score below the 50^th percentile of HEDIS Medicaid performance nationwide during the prior measurement year on a HEDIS-based measure, or below the calculated 50^th percentile among Maryland HealthChoice MCO performance for a non-HEDIS measure, shall be ineligible for a round one performance incentive payment.

(4) (text unchanged)

[J.] K. Round Two Incentive Payments.

(1) An MCO may qualify for payments under round two if the following conditions are met:

(a) For measurement years up to and including 2024:

[(a)] (i)—[(b)] (ii) (text unchanged)

(b) For measurement year 2025, the MCO earned above 80 percent of possible round one incentives; and

(c) Effective measurement year 2026, the MCO earned above 75 percent of possible round one incentives.

(2) [Any] Subject to budget approval, any remaining funds that were unallocated during round one may be awarded to eligible MCOs in round two for a maximum incentive award of up to 1 percent of its total capitation payment during the PHIP measurement year, excluding supplemental payments outside of capitation.

(3) (text unchanged)

[K.] L.—[M.] N. (text unchanged)

.20 MCO Payment for Self-Referred, Emergency, Physician, and Hospital Services.

A. MCO Payment for Self-Referred Services.

(1)—(10) (text unchanged)

(11) An MCO shall reimburse out-of-plan doulas at the Medicaid fee-for-service rate for services performed during the prenatal, labor and delivery, and postpartum periods of pregnancy as described in COMAR 10.67.06.28 through December 31, [2025] 2026.

B.—E. (text unchanged)

10.67.06 Maryland Medicaid Managed Care Program: Benefits

Authority: Health-General Article, Title 15, Subtitle 1, Annotated Code of Maryland

.07 Benefits—Inpatient Hospital Services.

A.—D. (text unchanged)

E. In addition to the mother's length of stay required to be afforded by §D(2) of this regulation, whenever a mother is required to remain hospitalized after childbirth for medical reasons and [she requests that] her newborn remains in the hospital while she is hospitalized, the MCO shall afford the newborn additional hospitalization while the mother remains hospitalized, for up to 4 days.

F.—I. (text unchanged)

.28 Benefits—Self-Referral Services.

A. An MCO shall be financially responsible for reimbursing, in accordance with COMAR 10.67.04.20, an out-of-plan provider chosen by the participant for the following services:

(1)—(9) (text unchanged)

(10) Doula services, through December 31, [2025] 2026.

B.—C. (text unchanged)

10.67.09 Maryland Medicaid Managed Care Program: MCO Dispute Resolution Procedures

Authority: Health-General Article, §15-103(b)(9)(i)(4), Annotated Code of Maryland

.02 MCO Enrollee Complaint Process.

A.—B. (text unchanged)

C. An MCO shall submit for Department approval an internal complaint process detailing the procedures for registering and responding to appeals and grievances in a timely fashion, which:

(1) Includes a specific standard for grievance acknowledgement, monitored by the MCO for compliance, directing that:

(a) The length of time preceding a written acknowledgement of a grievance may not exceed 5 days; and

(b) For administrative and non-emergency grievances, if the complaint is resolved in 5 days or less, the resolution letter can serve as written acknowledgement.

[(1)] (2)—[(6)] (7) (text unchanged)

.04 MCO Actions and Decisions.

A. For certain services to enrollees that require preauthorization the following conditions apply:

(1) For standard authorization decisions, the MCO shall make a determination within 2 business days of receipt of necessary clinical information, but not later than [14] 7 calendar days from the date of the initial request so as not to adversely affect the health of the enrollee;

(2)—(5) (text unchanged)

B.—G. (text unchanged)

MEENA SESHAMANI, MD, PHD
Secretary of Health

Title 14
INDEPENDENT AGENCIES

Subtitle 22 COMMISSION ON CRIMINAL SENTENCING POLICY

Authority: Criminal Procedure Article, § 6-211, Annotated Code of Maryland.

Notice of Proposed Action

[26-048-P]

The Maryland State Commission on Criminal Sentencing Policy proposes to:

(1) Amend Regulations .01, .02, and .10 under COMAR 14.22.01 General Regulations; and

(2) Amend Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness Categories.

Statement of Purpose

The purpose of this action is to modify Regulations .01, .02, and .10 under COMAR 14.22.01 General Regulations to clarify that criminal desertion is not a guidelines offense. This is not a new guideline rule but rather clarification of an existing rule. Additionally, the purpose of this action is to modify Regulation .02 under COMAR 14.22.02 Criminal Offenses and Seriousness Categories to reflect:

(1) The addition of three previously unclassified offenses;

(2) The reclassification of one offense from property to person;

(3) The addition of two offenses with a maximum penalty of 1 year or less since they may be prosecuted in circuit courts; and

(4) Minor edits to the table, including a slight revision to an offense description and the correction of a statute.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to David Soule, Executive Director, Maryland State Commission on Criminal Sentencing Policy, 4511 Knox Rd, Suite 309, College Park, MD 20740, or call 301-403-4165, or email to [email protected]. Comments will be accepted through June 1, 2026. A public hearing has not been scheduled.

14.22.01 General Regulations

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland.

.01 Scope.

A. The Maryland sentencing guidelines apply to criminal cases prosecuted in a circuit court. The following sentencing matters handled by judges in a circuit court are excluded from guidelines coverage:

(1)—(5) (text unchanged)

(6) Criminal nonsupport, desertion, and [criminal] contempt; and

(7) (text unchanged)

B. (text unchanged)

.02 Definitions.

A. (text unchanged)

B. Terms Defined.

(1)—(9) (text unchanged)

(10) Guidelines Offense.

(a)—(b) (text unchanged)

(i)—(v) (text unchanged)

(vi) Criminal nonsupport, desertion, and [criminal] contempt; and

(vii) (text unchanged)

(11)—(27) (text unchanged)

.10 Computation of the Offender Score.

A. (text unchanged)

B. Four Components of the Offender Score.

(1)—(2) (text unchanged)

(3) Prior Adult Criminal Record.

(a) In General.

(i) Except as noted in this paragraph, the prior adult criminal record includes all adjudications preceding the current sentencing event, whether the offense was committed before, during, or after the instant offense(s). The prior adult criminal record shall not include: adjudications that were expunged from the record or proven by the defense to have been eligible for expungement as a matter of right prior to the date of offense pursuant to Subtitle 1 (Expungement of Police and Court Records) of Title 10 (Criminal Records) of the Criminal Procedure Article, Annotated Code of Maryland; violations of public local laws; municipal infractions; [contempt;] criminal nonsupport, desertion, and contempt; adjudications based on acts that are no longer crimes (e.g., cannabis possession); non-incarcerable traffic offenses; military adjudications imposed by an Article 15 proceeding or summary court-martial; findings of guilt by general or special courts-martial, if the elements of the offense require the defendant’s service in a military force, including but not limited to desertion, absence without leave (AWOL), and conduct unbecoming an officer and a gentleman, or do not constitute an offense under Maryland law; or more than one adjudication arising from a single criminal event.

(ii)—(iv) (text unchanged)

(b)—(h) (text unchanged)

(4) (text unchanged)

C. (text unchanged)

14.22.02 Criminal Offenses and Seriousness Categories

Authority: Criminal Procedure Article, §6-211, Annotated Code of Maryland

.02 Seriousness Categories.

	Offense Literal	CJIS Code	Source	Felony or Misd.	Max Term	Min Term	Offense Type	Ser. Category	Fine
1—36-11 (text unchanged)
36-12	Boating Offenses Failure to immediately stop a vessel involved in a collision, accident, or other casualty when the person knew or reasonably should have known that the death of another person might occur and death actually occurred		[NR, §8-724(3)(iii)(2)] NR, §8-724(a)(3)(iii)(2)	Felony	10Y		Person	IV	$10,000
37—64 (text unchanged)
65	CDS and Paraphernalia Paraphernalia—possess or distribute controlled paraphernalia—non-cannabis, subsequent	1-2214 1-2215	CR, §5-620(d)(2)	Misd.	1Y		Drug	VII	$1,000
66—93 (text unchanged)
94 [Vacant]	*Commercial Fraud, Other* Providing heating, ventilation, air-conditioning, or refrigeration services without a license; employing unlicensed individuals; misrepresentation as license holder, 1^st offense	1-1429 2-0672 2-0673 2-0674 2-0675	BR, §9A-501 BR, §9A-502 BR, §9A-503 BR, §9A-504 BR, §9A-505(a)(2) (penalty)	Misd.	6M		Property	VII	$1,000
94-1	*Commercial Fraud, Other* Providing heating, ventilation, air-conditioning, or refrigeration services without a license; employing unlicensed individuals; misrepresentation as license holder, subsequent	1-1429 2-0672 2-0673 2-0674 2-0675	BR, §9A-501 BR, §9A-502 BR, §9A-503 BR, §9A-504 BR, §9A-505(a)(2) (penalty)	Misd.	2Y		Property	VII	$5,000
95—159-5 (text unchanged)
159-6	Fraud, Miscellaneous Practicing Polysomnography without a license		HO, §§14-5C-20 — 14-5C-22 HO, §14-5C-23(a) (penalty)	Misd.	1Y		[Property] Person	VII	$1,000
159-7—257 (text unchanged)
257-1	*Motor Vehicle Offense* Obtaining, or attempting to obtain, a driver’s license or moped operator’s permit by misrepresentation		TR, §16-301(a), (b) TR, §16-301(r)(2) (penalty)	Misd.	3Y		Property	VII	$2,500
258—263 (text unchanged)
263-1	*Motor Vehicle Offense* Commit fraud or misrepresentation in applying for an identification card		TR, §12-301(c), (d) TR, §12-301(m)(1) (penalty)	Misd.	3Y		Property	VII	$2,500
264—366-3 (text unchanged)
366-4	*Surveillance and Other Crimes Against Privacy* Conduct or procure another to conduct visual surveillance of an individual in a private place without their consent (“peeping Tom”)	1-0013	CR, §3-901	Misd.	30D		Person	VII	$1,000
367—421 (text unchanged)

Footnotes (text unchanged)

General Rules: (text unchanged)

DAVID A SOULE
Executive Director

Errata

COMAR 13A.01.05

At 53:5 Md. R. 298 (March 20, 2026), column 1, lines 25—30 from the top:

For:

Statement of Purpose

The purpose of this action is to add a process for request of interim relief during the period in between an individual’s submission of a request for the State Board to issue charges for removal of a local member of a board of education and when the State Board issues a final decision on the removal request.

Read:

Statement of Purpose

The purpose of this action is to change the procedures applicable to requests to remove a local board member by adding a process for request of interim relief during the period in between an individual’s submission of a request for the State Board to issue charges for removal of a local member of a board of education and when the State Board issues a final decision on the removal request.

[26-09-027]

Special Documents

DEPARTMENT OF NATURAL RESOURCES

FISHING AND BOATING SERVICES

PUBLIC NOTICE

Price Paid for Purchasing, Hauling, and Planting Fresh Oyster Shell — Effective

April 1, 2026

WHAT THIS NOTICE DOES

The Secretary of the Maryland Department of Natural Resources announces the maximum price the Department will pay to purchase fresh oyster shell from oysters harvested and sold within Maryland and the maximum price the Department will pay to haul and plant fresh shell harvested and sold either in Maryland or another state.

· Shell:

o $4.75 per bushel if Department staff load and truck the shell.

o $5.25 per bushel if the shell owner loads into DNR trucks or onto planting vessels.

o $5.75 per bushel if the shell owner loads and trucks the shell to DNR designated location.

· Hauling and planting: $2.50 per bushel

WHO THIS NOTICE AFFECTS

This notice applies to all individuals who sell fresh oyster shell and transport and plant fresh shell as part of the Department’s restoration and replenishment programs.

EFFECTIVE DATE

This notice is effective at 12:01 a.m. April 1, 2026.

AUTHORITY

Code of Maryland Regulations 08.02.04.11G

ADDITIONAL INFORMATION

Code of Maryland Regulations 08.02.04.11 requires the Department to set the maximum price the Department will pay for a bushel of fresh shells from oysters harvested and sold within Maryland as the fair market price via a public notice. The Department reviews the maximum shell purchase price and the transport/plant price annually prior to the start of each planting season and set these prices at that time.

FOR FURTHER INFORMATION CONTACT:

Fishing and Boating Services at 410-260-8302

Josh Kurtz

Secretary of Natural Resources

[26-09-14]

PUBLIC NOTICE

Commercial Mature Female Hard Crab Catch Limits — Effective April 1, 2026

WHAT THIS NOTICE DOES

The Secretary of the Maryland Department of Natural Resources, in consultation with the Blue Crab Industry Advisory Committee, announces the commercial mature female hard crab catch limits for the Chesapeake Bay and its tidal tributaries for April 1 through June 30, 2026. Effective 12:01 a.m. April 1, 2026, the catch limits are:

Daily Mature Female Hard Crab Catch Limits by License Type
Date	Container	LCC	TFL or CB3	TFL with CB6 or CB3 with CB6	TFL with CB9 or CB3 with CB9
April 1 - May 31, 2026	Bushel	2	6	9	13
	Lug	1	4	6	8
	Barrel	N/A	2	3	5
June 1 - 30, 2026	Bushel	2	9	13	16
	Lug	1	6	8	10
	Barrel	N/A	3	5	6
License Acronyms LCC – Limited Crab Harvester License (up to 50 pots) TFL – Unlimited Tidal Fish License CB3 – 300 Pot Crab Harvester License CB6 – 600 Pot Crab Harvester License CB9 – 900 Pot Crab Harvester License Container Definitions Bushel, circular – A circular container with inside dimensions not exceeding 12” height, 18” top diameter, 13-½” bottom diameter Bushel, rectangular – A rectangular container with inside dimensions not exceeding 11” height, 19-½” length, 12-½” width Lug – A rectangular container with inside dimensions not exceeding 12-⅜” height, 22-⅞” top length, 14-⅞” top width, 21” bottom length, 13” bottom width Barrel – A circular container with inside dimensions not exceeding 27-½” height, 20-½” top diameter, 18” bottom diameter NOTE: The 2-bushel limit for LCC license holders invalidates a barrel for use because a barrel holds a minimum of 2.5 bushels of crabs.

Daily catch limits for mature female hard crabs are based on the Blue Crab Winter Dredge Survey results, conducted by the Maryland Department of Natural Resources and the Virginia Institute of Marine Science, and in consultation with the Blue Crab Industry Advisory Committee.

All catch of mature female hard crabs on board a vessel must be kept in the same type of container, although crabs of different sexes may be kept in different types of containers. For example, a harvester may have all females in lugs and all males in bushels but could not have males and females in both bushels and lugs. Commercial crabbers using lugs should report harvest in pounds when completing Commercial Harvest Reports.

Crew limits as described in Annotated Code of Maryland, Natural Resources Article, §4-814, are in effect. If crew members are not on board, then the licensee is restricted to the TFL or CB3 catch limits.

WHERE THIS NOTICE APPLIES

This applies to the Chesapeake Bay and its tidal tributaries, including the Maryland tributaries of the Potomac River.

WHY THIS IS NECESSARY

This action is necessary to ensure female blue crab harvest does not exceed the Chesapeake Bay exploitation threshold established in Amendment 2 to the Chesapeake Bay Blue Crab Fishery Management Plan.

WHO THIS NOTICE AFFECTS

This applies to commercial crabbers who harvest female blue crabs in the Chesapeake Bay and its tidal tributaries.

AUTHORITY

Code of Maryland Regulations 08.02.03.14G

JOSH KURTZ

Secretary of Natural Resources

[26-09-11]

PUBLIC NOTICE

2026 Sponge Crab Importation Dates—Effective April 1, 2026

WHAT THIS NOTICE DOES

The Secretary of the Maryland Department of Natural Resources, in consultation with the Blue Crab Industry Advisory Committee, announces that female blue crabs from which the egg pouch or bunion has been removed, or egg-bearing female blue crabs known as sponge crabs, may be imported into Maryland from another state by a dealer or crab processing plant only during the period May 11, 2026 through July 20, 2026. Dealers and crab processing plants must have a bill of sale or lading from the jurisdiction of origin and may not import the crabs at any other time of the year.

WHY THIS IS NECESSARY

This action is necessary to implement the Chesapeake Bay Blue Crab Management Plan. The time period specified ensures minimal disruptions to the crab processing plant industry.

WHO THIS NOTICE AFFECTS

This applies to seafood dealers and processors who purchase and import egg-bearing female blue crabs in the state of Maryland.

AUTHORITY

Code of Maryland Regulations 08.02.03.08C

JOSH KURTZ

Secretary of Natural Resources

PUBLIC NOTICE

2025-2026 Commercial Yellow Perch—Closure of Upper Bay—Effective 3/21/2026

WHAT THIS NOTICE DOES

The Secretary of the Maryland Department of Natural Resources announces the closure of the 2025-2026 commercial yellow perch fishery in the Upper Bay, effective 12:01 a.m. Saturday, March 21, 2026.

The Chester River and Patuxent River yellow perch fisheries will remain open through March 31, 2026. If the harvest target for the Chester River or Patuxent River is projected to be met prior to March 31, 2026, that area will be closed by public notice.

WHY THIS IS NECESSARY

This action is necessary because the Department is projecting that the annual commercial harvest target for the Upper Bay will be met.

WHO THIS NOTICE AFFECTS

This applies to all commercially licensed and permitted individuals who harvest yellow perch in the Upper Bay.

AUTHORITY

Code of Maryland Regulations 08.02.21.04

FOR FURTHER INFORMATION CONTACT:

Fishing and Boating Services at 410-260-8293

JOSH KURTZ

Secretary of Natural Resources

[26-09-13]

DEPARTMENT OF THE ENVIRONMENT

LAND AND MATERIALS ADMINISTRATION

NOTICE OF FINAL DETERMINATION

General Discharge Permit for Animal Feeding Operations State Discharge Permit No. 25AF; NPDES Permit No. MDG01

The Maryland Department of the Environment (MDE) is reissuing with revisions the General Discharge Permit (GD Permit) for Animal Feeding Operations (AFOs), Maryland Permit No. 25AF, NPDES Permit No. MDG01. This General Discharge Permit will replace Maryland Permit No. 19AF, NPDES Permit No. MDG01 that was effective July 8, 2020, and expired July 7, 2025.

The General Discharge Permit is necessary to protect water quality and to comply with federal requirements under 40 Code of Federal Regulations (CFR) Parts 122, 123, 124, 125, and 412, as well as state requirements under Code of Maryland Regulations (“COMAR”) 26.08.04.09N. All large and medium AFOs that discharge or propose to discharge to waters of the state must be covered under the General Discharge Permit. Other AFOs may be required to be covered under the General Discharge Permit at the discretion of MDE or the United States Environmental Protection Agency (“EPA”).

On October 3, 2025, MDE published a Notice of Tentative Determination to reissue with revisions the AFO General Discharge Permit. MDE conducted five public hearings on October 15, 2025 at the Thurmont Regional Library, 76 East Moser Road, Thurmont, Maryland 21788, October 21, 2025 at the University of Maryland Eastern Shore, Princess Anne, Maryland 21853, October 29, 2025 at the Talbot Community Center Curling Rink, Easton, Maryland 21601, October 30, 2025 virtual public hearing, November 18, 2025 at the First Baptist Church of Salisbury, 528 Booth Street Salisbury, MD 21801.

The public comment period was extended by 60 days, and written public comments were received by MDE through January 2, 2026. In addition to the General Discharge Permit revisions proposed in the Tentative Determination and non-substantive changes (including renumbering and spacing), MDE has made the following further revisions to the draft General Discharge Permit in response to comments received as part of the public participation process:

Table of Contents:

Fixed page number references.

Part III.A.2.:

Updated 2025 to 2028.

Part IV.A.1.b.vii:

Fixed spelling of “commingling”.

Part IV.B.3:

Fixed spelling of “ponds”.

Part IV.B.8:

Clarified that “wastewater” is “process wastewater”.

Part V.B.1:

Updated 2025 to 2028.

Part VII.M.1.d:

Fixed spelling of “ensure”.

Part VII.N:

Fixed typo from “renewal” to “expiration”.

Part VII.N:

Removed “or modifications of existing registrations” from the last sentence.

Table 3.h:

Clarified “Water line inspections must continue to be conducted between flocks unless animals are not present in the production area and the water lines are turned off or are not in service.

Table 4.e:

Clarified “Water line inspections must continue to be conducted between flocks unless animals are not present in the production area and the water lines are turned off or are not in service.

Part IV.B.3:

Clarified “Water line inspections must continue to be conducted between flocks unless animals are not present in the production area and the water lines are turned off or are not in service.

As provided by § 1-601(c) of the Environment Article, a Final Determination by the Department on the issuance, denial, renewal, or revision of the General Discharge Permit is subject to judicial review at the request of any person that: (1) Meets the threshold standing requirements under federal law; and (2) (i) Is the applicant; or (ii) Participated in the public participation process through the submission of written or oral comments, unless an opportunity for public participation was not provided. Judicial review is based on the administrative record before the Department and limited to objections raised during the public comment period unless the petitioner demonstrates that: (i) The objections were not reasonably ascertainable during the comment period; or (ii) Grounds for the objections arose after the comment period. Md. Code Ann., Envir. § 1-601(d). A person petitioning for judicial review shall file the petition in accordance with Title 1, Subtitle 6 of the Environment Article and the Maryland Rules. Md. Code Ann., Envir. § 1-605(a), (c). A party submitting a petition for judicial review shall file the petition within thirty (30) calendar days after publication of a notice of Final Determination. Md. Code Ann., Envir. § 1-605(b).

The General Discharge Permit and MDE’s “Response to Public Comments Regarding General Discharge Permit for Animal Feeding Operations, Maryland Permit # 25AF; NPDES Permit # MDG01” may be viewed on the Animal Feeding Operations Program Webpage: https://mde.maryland.gov/programs/LAND/RecyclingandOperationsprogram/Pages/AFOInfo.aspx

Copies of these documents may be obtained from MDE at a cost of $0.36 per page. For further information regarding this notice, please contact Alexis Capes, Chief, Animal Feeding Operations Division, Resource Management Program at (443) 827-0476 or [email protected].

[26-09-28]

SUSQUEHANNA RIVER BASIN COMMISSION

Projects Approved for Consumptive Uses of Water

AGENCY: Susquehanna River Basin Commission.

ACTION: Notice.

SUMMARY: This notice lists Approvals by Rule for projects by the Susquehanna River Basin Commission during the period set forth in DATES.

DATES: March 1 – 31, 2026.

ADDRESSES: Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA 17110-1788.

FOR FURTHER INFORMATION CONTACT: Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax: (717) 238-2436; e-mail: [email protected]. Regular mail inquiries may be sent to the above address.

SUPPLEMENTARY INFORMATION: This notice lists the projects, described below, receiving approval for the consumptive use of water pursuant to the Commission’s approval by rule process set forth in 18 CFR §806.22 (f ) for the time period specified above.

Approvals by Rule - Issued Under 18 CFR 806.22(f):

1. RENEWAL - Diversified Production LLC; Pad ID: Longhorn C-1 (WDV1); ABR-201011061.R3; Jay Township, Elk County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
2. RENEWAL - Expand Operating LLC; Pad ID: Beeman; ABR-201101028.R3; Litchfield Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
3. RENEWAL - Expand Operating LLC; Pad ID: Bustin Homestead; ABR-201101025.R3; Sheshequin Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
4. RENEWAL - Expand Operating LLC; Pad ID: Corl; ABR-201102011.R3; Colley Township, Sullivan County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
5. RENEWAL - Expand Operating LLC; Pad ID: DJ; ABR-201101021.R3; Wysox Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
6. RENEWAL - Expand Operating LLC; Pad ID: Garrison Drilling Pad #1; ABR-201102032.R3; Lemon Township, Wyoming County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
7. RENEWAL - Expand Operating LLC; Pad ID: Harnish; ABR-201102006.R3; Sheshequin Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
8. RENEWAL - Expand Operating LLC; Pad ID: Herr; ABR-201102026.R3; Sheshequin Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
9. RENEWAL - Expand Operating LLC; Pad ID: Jokah; ABR-201102005.R3; Windham Township, Wyoming County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
10. RENEWAL - Expand Operating LLC; Pad ID: Rocks; ABR-201101003.R3; Overton Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
11. RENEWAL - Expand Operating LLC; Pad ID: RU-74 TRETTER PAD; ABR-201601005.R2; Great Bend Township, Susquehanna County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
12. RENEWAL - Expand Operating LLC; Pad ID: Struble; ABR-201101017.R3; Litchfield Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
13. RENEWAL - Expand Operating LLC; Pad ID: VRGC; ABR-201101022.R3; Wilmot Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
14. RENEWAL - Expand Operating LLC; Pad ID: Walker; ABR-201101030.R3; Wilmot Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
15. RENEWAL - Expand Operating LLC; Pad ID: WY 09 OTTEN PAD; ABR-201512002.R2; Forkston Township, Wyoming County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 11, 2026.
16. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: UHOUSE (05 081) D; ABR-201102008.R3; Orwell Township, Bradford County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 11, 2026.
17. RENEWAL - Seneca Resources Company, LLC; Pad ID: Brewer 258; ABR-201012013.R3; Jackson Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
18. RENEWAL - Seneca Resources Company, LLC; Pad ID: DCNR 100 Pad C; ABR-201102007.R3; Cogan House Township, Lycoming County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
19. RENEWAL - Seneca Resources Company, LLC; Pad ID: Gee 848W; ABR-201508005.R2; Middlebury Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
20. RENEWAL - Seneca Resources Company, LLC; Pad ID: Harsell 883; ABR-201007066.R3; Nelson Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
21. RENEWAL - Seneca Resources Company, LLC; Pad ID: Martin 421; ABR-201009089.R3; Delmar Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
22. RENEWAL - Seneca Resources Company, LLC; Pad ID: Seymour 599; ABR-201009063.R3; Sullivan Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
23. RENEWAL - Seneca Resources Company, LLC; Pad ID: Shaw Trust 500; ABR-201011070.R3; Sullivan Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
24. RENEWAL - Seneca Resources Company, LLC; Pad ID: Signor 583; ABR-201011059.R3; Covington Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
25. RENEWAL - Seneca Resources Company, LLC; Pad ID: Smith 589; ABR-201009088.R3; Richmond Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
26. RENEWAL - Seneca Resources Company, LLC; Pad ID: Stanley 1106; ABR-201102015.R3; Osceola Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
27. RENEWAL - Seneca Resources Company, LLC; Pad ID: Torpy & Van Order Inc 574; ABR-201011043.R3; Covington Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
28. RENEWAL - Seneca Resources Company, LLC; Pad ID: Vanvliet 614; ABR-201012044.R3; Delmar Township, Tioga County, Pa.; Consumptive Use of Up to 4.0000 mgd; Approval Date: March 11, 2026.
29. RENEWAL - VEC Energy LLC; Pad ID: Austinburg 1H; ABR-20100313.R3; Brookfield Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 11, 2026.
30. RENEWAL - Expand Operating LLC; Pad ID: Wasyl; ABR-201101002.R3; Ulster Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 17, 2026.
31. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: PECK HILL FARM (05 178); ABR-201101019.R3; Windham Township, Bradford County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 17, 2026.
32. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: Red Tailed Hawk; ABR-201011027.R3; Covington Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 17, 2026.
33. RENEWAL - BKV Operating, LLC; Pad ID: Yarasavage Well Pad; ABR-201102021.R3; Washington Township, Wyoming County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 23, 2026.
34. RENEWAL - Expand Operating LLC; Pad ID: Demento Pad; ABR-201102036.R3; Stevens Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 23, 2026.
35. RENEWAL - S.T.L. Resources, LLC; Pad ID: Sturgis South; ABR-202102004.R1; Grugan Township, Clinton County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 23, 2026.
36. RENEWAL - Coterra Energy Inc.; Pad ID: HawleyJ P1; ABR-201103009.R3; Forest Lake Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 27, 2026.
37. RENEWAL - Coterra Energy Inc.; Pad ID: HeitzenroderA P2; ABR-202103002.R1; Springville Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 27, 2026.
38. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: ANTISDEL (05 036) M; ABR-201009016.R3; Warren Township, Bradford County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 27, 2026.
39. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: Guillaume 715; ABR-201011002.R3; Liberty Township, Tioga County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 27, 2026.
40. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: HARTNETT (05 097) R; ABR-201010045.R3; Orwell Township, Bradford County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 27, 2026.
41. RENEWAL - Repsol Oil & Gas USA, LLC; Pad ID: WATKINS (03 052) M; ABR-201011048.R3; Columbia Township, Bradford County, Pa.; Consumptive Use of Up to 6.0000 mgd; Approval Date: March 27, 2026.
42. RENEWAL - Coterra Energy Inc.; Pad ID: Ely P3; ABR-20080709.R3; Dimock Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 31, 2026.
43. RENEWAL - Coterra Energy Inc.; Pad ID: Teel P3; ABR-20080702.R3; Springville Township, Susquehanna County, Pa.; Consumptive Use of Up to 5.0000 mgd; Approval Date: March 31, 2026.
44. RENEWAL - Expand Operating LLC; Pad ID: Acton; ABR-201103013.R3; Rome Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 31, 2026.
45. RENEWAL - Expand Operating LLC; Pad ID: DPH; ABR-201103011.R3; Windham Township, Wyoming County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 31, 2026.
46. RENEWAL - Expand Operating LLC; Pad ID: Dziuba; ABR-201103012.R3; Tuscarora Township, Bradford County, Pa.; Consumptive Use of Up to 7.5000 mgd; Approval Date: March 31, 2026.
Authority: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

JASON E. OYLER
General Counsel and Secretary to the Commission.

Dated: April 10, 2026

[26-09-17]

General Permit Notice

AGENCY: Susquehanna River Basin Commission.

ACTION: Notice.

SUMMARY: This notice lists General Permits approved by the Susquehanna River Basin Commission during the period set forth in DATES.

DATES: March 1-31, 2026

ADDRESSES: Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA 17110-1788.

FOR FURTHER INFORMATION CONTACT: Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax (717) 238-2436; e-mail: [email protected]. Regular mail inquiries may be sent to the above address.

SUPPLEMENTARY INFORMATION: This notice lists General Permits for projects, described below, pursuant to 18 CFR § 806.17(c)(4), for the time period specified above.

1. Pennsylvania Department of Environmental Protection – Bureau of Abandoned Mine Reclamation; Hanover Reservoir Mine Fire, General Permit Approval of Coverage No. GP-02-202603022, Hanover Township, Luzerne County, Pa.; Extinguish a Mine Fire; Consumptive use approved up to 0.068 mgd (30-day average) from Well 1; Approval Date: March 3, 2026.

Authority: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

Dated: April 10, 2026.

Jason E. Oyler,

General Counsel and Secretary to the Commission.

[26-09-18]

Grandfathering Registration Notice

AGENCY: Susquehanna River Basin Commission.

ACTION: Notice.

SUMMARY: This notice lists Grandfathering Registration for projects by the Susquehanna River Basin Commission during the period set forth in DATES.

DATES: March 1-31, 2026.

ADDRESSES: Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA 17110-1788.

FOR FURTHER INFORMATION CONTACT: Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax: (717) 238-2436; e-mail: [email protected]. Regular mail inquiries may be sent to the above address.

SUPPLEMENTARY INFORMATION: This notice lists GF Registration for projects, described below, pursuant to 18 CFR Part 806, Subpart E, for the time period specified above:

1. Heidelberg Materials Northeast LLC – Salona Quarry, GF Certificate No. GF‑202603312, Lamar Township, Clinton County, Pa.; the Active Pit Sump and consumptive use; Issue Date: March 9, 2026.

2. National Limestone Quarry, Inc. – Paxtonville Facility, GF Certificate No. GF-202603313, Franklin and Beaver Townships, Snyder County, Pa.; Well 1 and consumptive use; Issue Date: March 23, 2026.

Authority: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

Dated: April 10, 2026

JASON E. OYLER,

General Counsel and Secretary to the Commission.

[26-09-19]

Minor Modification Approval

AGENCY: Susquehanna River Basin Commission.

ACTION: Notice.

SUMMARY: This notice lists the minor modifications approved for previously approved projects by the Susquehanna River Basin Commission during the period set forth in DATES.

DATES: March 1-31, 2026

ADDRESSES: Susquehanna River Basin Commission, 4423 North Front Street, Harrisburg, PA 17110-1788.

FOR FURTHER INFORMATION CONTACT: Jason E. Oyler, General Counsel and Secretary to the Commission, telephone: (717) 238-0423, ext. 1312; fax (717) 238-2436; e-mail: [email protected]. Regular mail inquiries may be sent to the above address.

SUPPLEMENTARY INFORMATION: This notice lists previously approved projects, receiving approval of minor modification or a corrective modification, described below, pursuant to 18 CFR § 806.18 or to Commission Resolution Nos. 2013-11 and 2015-06, for the time period specified above.

1. East Cocalico Township Authority – Well 10, Docket No. 20260316, East Cocalico Township, Lancaster County, Pa.; modification approval to remove Well 10 from approved sources; Approval Date: March 25, 2026.

Authority: Public Law 91-575, 84 Stat. 1509 et seq., 18 CFR parts 806 and 808.

Dated: April 10, 2026

JASON E. OYLER,

General Counsel and Secretary to the Commission.

[26-09-20]

WATER AND SCIENCE ADMINISTRATION

Federal Consistency Determination

Baltimore District, U.S. Army Corps of Engineers

2 Hopkins Plaza

Baltimore, MD 21201

Add’l. Info: The Maryland Department of the Environment (MDE) is providing notice of a request for concurrence under the federal Coastal Zone Management Act (CZMA).

Location: Rock Hall Harbor, Kent County, MD.

The U.S. Army Corps of Engineers (USACE), Baltimore District, has requested Coastal Zone Management Act (CZMA) Federal Consistency Determination (FCD) to perform maintenance dredging on selected portions of the Rock Hall

Federal Navigation Project to restore the channels to their authorized dimensions, with an additional two feet of allowable overdepth. The project will involve the mechanical dredging of up to 100,000 cubic yards of material. This material will be transported from a barge onto trucks and transported in approximately 2,300 truckloads to the Dudley Orem Pit, a licensed sand and gravel mine in Kent County located seven miles from the harbor and one mile south of Fairlee, off of Maryland Route 20 (Rock Hall Road). All dredging and placement activities will be completed within a 180-day period, beginning no earlier than October 16, 2026, and concluding by April 14, 2027, to protect local aquatic resources.

The purpose of this notice is to solicit comments from the public about the proposed work. At this time, no decision has been made regarding a Federal consistency concurrence determination. Written comments will be accepted until June 1, 2026.

Contact: Danielle Spendiff at [email protected] or 410-537-4023.

[26-09-25]

Water Quality Certification 25-WQC-0035

Anne Arundel County Department of Public Works

2662 Riva Rd

Annapolis, MD 21401

Add’l. Info: Pursuant to COMAR 26.08.02.10F(3)(c), The Maryland Department of the Environment is providing notice of its issuance of a Water Quality Certification 25-WQC-0035.

Location: 839 Londontown Rd, 39.941779, -76.539811, Edgewater, (Anne Arundel), MD 21037

The purpose of the project is to improve navigable access and stabilize an eroding shoreline.

Description of Authorized Work:

1. REACH 1:

a. Remove an existing pier and associated structures;

b. Construct a 324-foot long by 8-foot wide fixed pier with a 90-foot long by 10-foot wide fixed “T” shaped platform, two fixed 10-foot long by 8-foot wide platforms, a 60-foot long by 8-foot wide fixed sloped pier, a 27-foot long by 10-foot wide floating platform, a 100-foot long by 8-foot wide floating platform, a 22-foot long by 5-foot wide aluminum gangway, and two timber dolphin pile clusters, all within a maximum of 334 feet channelward of the mean high water line;

c. Construct a 658-linear feet of low profile stone, sand containment sill, incorporating coarse woody debris; and fill and grade with 3,660 cubic yards of sand along 640 feet of an existing bulkhead and plant with 8,142 square feet of low marsh vegetation, 2,234 square feet of high marsh vegetation, and 12,902 square feet of upland vegetation extending a maximum of 85 feet channelward of the mean high water line;

d. Construct 56 linear feet of riprap armor within 10 feet of the existing bulkhead.

e. Construct 21-foot long by 8-foot wide and a 45-foot long by 4-foot wide cobble outfalls that drain upland stormwater into open water tidal wetlands, both within a maximum of 45 feet channelward of the mean high water line.

2. REACH 2:

a. Remove an existing pier and associated pilings;

b. Construct 213 linear feet of low profile stone, sand containment sill, incorporating coarse woody debris; and fill and grade with 367 cubic yards of sand along 183 feet of eroding shoreline and plant with 6,081 square feet of low marsh vegetation within a maximum of 70 feet channelward of the mean high water line

The WQC and its attachments may be viewed at the following link:

https://mde.maryland.gov/programs/Water/WetlandsandWaterways/Pages/WQC.aspx

Appeal of Final Decision: This Water Quality Certification is a final agency decision. Any person aggrieved by the Department’s decision to issue this WQC may appeal such decision in accordance with COMAR 26.08.02.10F(4). A request for appeal shall be filed with the Department within 30 days of publication of the final decision and specify in writing the reason why the final decision should be reconsidered. A request for appeal shall be submitted to: Secretary of the Environment, Maryland Department of the Environment, 1800 Washington Boulevard, Baltimore, MD 21230. Any request for an appeal does not stay the effectiveness of this WQC.

Contact: Mel Throckmorton at [email protected] or 410-375-2803.

[26-09-24]

Issue Date	Emergency and Proposed Regulations 5 p.m.*	Notices, etc. 10:30 a.m.	Final Regulations 10:30 a.m.
2026
May 15	April 27	May 4	May 6
May 29	May 11	May 18	May 20
June 12**	May 22	June 1	June 3
June 26	June 8	June 15	June 17
July 10	June 22	June 29	July 1
July 24	July 6	July 13	July 15
August 7	July 20	July 27	July 29
August 21	August 3	August 10	August 12
September 4	August 17	August 24	August 26
September18**	August 31	September 4	September 9
October 2	September14	September21	September23
October 16	September28	October 5	October 7
October 30**	October 9	October 19	October 21
November 13	October 26	November 2	November 4
November30***	November 9	November16	November18
December 11	November23	November30	December 2
December28***	December 7	December14	December16