Maryland Revived Its Behavioral Health Rate Study With a 2028 Deadline: What the New Workgroup Means for You

Your OMHC's Medicaid rates were set years ago, under a methodology nobody currently on staff was in the room for. Every year the cost of running the program goes up: rent, payroll, supervision, the software you use to stay compliant. The rate does not move to match it, or it moves by a fraction of a percent tucked into a fee schedule update nobody reads past the first page.

That is the complaint behind a law the General Assembly passed this year. It does not fix your rate. What it does is revive a rate study the state promised in 2017 and never carried out, put a new deadline on it, and build a workgroup around it. The early stages are happening now, and if you are filling out the Myers and Stauffer cost survey this week, you are already in one of them.

What the law actually does

House Bill 772 and Senate Bill 39 are companion bills that passed together this session and took effect July 1, 2026, as Chapter 219 and Chapter 218. They do two things. First, they take the independent, cost driven rate study that the 2017 HOPE Act already required and set a hard deadline for it: the Maryland Department of Health must complete it by June 30, 2028, administer the cost reporting tools that feed it, and oversee the cost report submissions. Second, they create a Workgroup on Behavioral Health Rate Methodology Modernization inside the Maryland Health Care Commission to develop cost based reimbursement methodologies for three provider types: certified community behavioral health clinics, outpatient mental health centers, and independent outpatient providers.

The stated goal is a reimbursement methodology grounded in what it actually costs to deliver the service, not the historical rate with periodic across the board bumps.

The workgroup itself is a mix of legislators, state officials, and the industry: one member of the Senate and one of the House, the executive director of the Maryland Health Care Commission or a designee, a representative of Medicaid, a representative of the Behavioral Health Administration, three community behavioral health providers through the Community Behavioral Health Association, a representative of the Licensed Clinical Professional Counselors of Maryland, a representative of MedChi, and several jointly appointed members covering hospitals, specialty psychiatric hospitals, consumer and peer advocacy, and actuarial or health economics expertise. The presiding officers of the General Assembly jointly name one legislator and one provider representative as co-chairs.

What it does not do

The bill is explicit about what it is not. Both the chapter text and the fiscal note say the law does not require an immediate rate increase, does not mandate an appropriation, and does not create a fiscal obligation in the absence of further legislative or budget action.

In plain terms: this is a study and a process, not a check. Any rate change that comes out of it needs a separate law or budget action to take effect.

This has happened before

Maryland ordered this study once already. The 2017 HOPE Act (the Heroin and Opioid Prevention Effort Act) required the Behavioral Health Administration and Medicaid to conduct an independent, cost driven rate setting study for community behavioral health services by September 30, 2019, and to build a payment system from it. That same law guaranteed payment increases of 3.5 percent in each of two fiscal years and 3 percent in the year after that.

The increases happened. The study did not. The Department of Legislative Services' fiscal note on this year's bill says it directly: "While the study has not yet occurred." What MDH did instead, after stakeholder discussions in 2019 and 2020, was split the work into two phases: first design a cost report template for providers, then collect the data and run the analysis. That first phase is the Myers and Stauffer cost survey sitting in your inbox with a September 30 deadline.

That history matters for how you read this year's law. The 2017 version paired its study with a guaranteed increase written into statute and no enforcement on the study itself. This year's version flips that: a deadline and a workgroup for the study, and no guaranteed increase. Whatever comes out of the workgroup will need its own follow up legislation or budget action to change what you get paid.

The timeline

Nothing here moves fast, but the dates are worth putting on a calendar now rather than relearning them in 2027:

• Now through 2027: the workgroup meets, and the Department of Health administers cost reporting tools and oversees cost report submissions needed to support the study. The Maryland Health Care Commission may require community providers to submit cost information for this purpose. The workgroup is required to use the federal CCBHC cost study as its baseline dataset, and its sampling methodology must exclude every program founded after 2020.
• June 1, 2027: the workgroup's interim report is due.
• December 1, 2027: the workgroup's final report is due, including recommended rate methodologies, cost components, and implementation options.
• January 1, 2028: the Health Care Commission submits its own interim report on delivery system and payment system recommendations.
• June 30, 2028: MDH's deadline to complete the rate study, and the date the workgroup terminates.
• December 1, 2028, and annually after that: the Commission reports on the impact of any rate adjustments.

Why your cost data matters starting now, not in 2027

The operative phrase in the law is that the Department "shall administer cost reporting tools and oversee cost report submissions required to support the study." That is not scheduled for some future date. It describes the Myers and Stauffer cost survey, due September 30, that we covered in detail earlier this month. The survey is the cost reporting tool; the study it feeds is the one this law now requires MDH to finish by June 2028; the workgroup is required to build on "all previously completed and ongoing cost reporting and analytical work," which is this survey by name if not by title.

So the survey is not a one off. It is the first data set in a process that runs to 2028, and the workgroup's own rules say the sample excludes programs founded after 2020. If your program predates 2020 and files a complete survey, your costs are in the base. If it does not file, the base is built without you.

That has a practical consequence for OMHCs and CCBHCs in particular. Whatever cost figures your program reports this year, to Myers and Stauffer now or to MHCC later, are not throwaway paperwork. A rate methodology built on cost data will only be as accurate as the cost data providers actually submitted. A program that under-reports overhead, mis-allocates shared costs across service lines, or simply files late and incomplete is quietly shaping its own rate ceiling two years out.

What to do this week

1. If your program is an OMHC, a CCBHC, or an independent outpatient provider, confirm you know who owns cost reporting on your team, and that it is not a task that falls through the cracks between the billing lead and the accountant.
2. Pull together a clean picture of your actual cost per service line now, even informally, so you are not reconstructing it under deadline pressure the next time a cost report request lands.
3. If you have not filed the September 30 HOPE Act cost report yet, do that first. See our earlier article for what it requires.
4. Watch for the workgroup's June 2027 interim report. That is the first real signal of which direction a new methodology is heading, and it is worth eighteen months of lead time to prepare for whatever it recommends.
5. If you have a relationship with the Community Behavioral Health Association or another group with a seat at the workgroup table, that is your channel for input before recommendations are locked in.

The documentation angle

Every rate study this state has ordered has depended on providers reporting their own costs accurately. That was the premise of the 2017 study that never happened, and it is the premise of this one. The programs whose cost reporting is easiest, meaning costs are already tracked by program and service line rather than lumped together, spend less time scrambling every time a new data request lands, and file numbers they can actually stand behind if a rate methodology built partly on that data ever gets challenged.