Maryland Department of Health
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May 20, 2025

Media Contact:
Chase Cook, Director, Office of Communications, 410-767-8649

Maryland Department of Health proposes new regulations to reduce fraud, waste in the behavioral health system
Public comment period ends June 16, 2025

Baltimore, MD—The Maryland Department of Health today announced that it seeks public comment on proposed new regulations for community-based behavioral health programs. These regulations provide clear and comprehensive guidelines and address long-standing issues regarding COMAR 10.63 regulations. 

These changes propose clearer standards, establish staffing requirements, streamline the licensing process and strengthen the enforcement capabilities the Behavioral Health Administration has over providers.

“This action marks a significant step in combating fraud and ensuring quality health care for all Marylanders,” said Maryland Health Secretary Dr. Meena Seshamani. “As a regulator and state behavioral health authority, we take our responsibility to provide behavioral health care seriously. Maryland individuals and families deserve high-quality health care services they can trust.”

This proposed regulation is the second phase of a three-phased regulatory approach to significantly strengthen oversight of more than 1,000 providers:

  • Phase 1: Civil Money Penalties (10.63.08) – New regulations finalized April 14, 2025, create for the first time civil money penalties for community-based behavioral health organizations with material and egregious violations of state or federal laws or regulations. 
  • Phase 2: Propose regulations today that address long-standing issues regarding vagueness and inconsistent interpretations of the COMAR 10.63 regulations for community-based behavioral health programs.
  • Phase 3: Propose regulations in the Summer of 2025 that create more detailed requirements for each licensed program type. 
The proposed changes announced today include: 

  • Chapter 1: Compliance and Reporting Requirements (10.63.01): This chapter proposes clear standards to reduce misinterpretation and enhance the Department's ability to ensure consistent provider accountability.
  • Chapter 2: Staffing Requirements (10.63.02): This chapter establishes the staffing requirements for all community-based behavioral health organizations licensed under this subtitle. By establishing these necessary staffing patterns, the Department aims to improve its oversight of service delivery and ensure that organizations have the appropriate personnel to provide services effectively. 
  • Chapter 6: Application and Licensure Process (10.63.06): This chapter provides clear application requirements and licensing procedures for community-based behavioral health organizations. In doing so, the Department aims to streamline submission, review, and decision-making, and enhance the ability to ensure that all licensed organizations fully comply with relevant regulations.
  • Chapter 9: Corrective Actions and Sanctions for Non-Compliance (10.63.09): This chapter strengthens the potential actions the Department might take when provider organizations fail to meet the regulatory requirements, as well as creating more transparency with provider organizations regarding the disciplinary measures that may be implemented for non-compliance.
The proposals, published May 16, 2025, incorporate the valuable feedback obtained from regional stakeholder meetings across the state, with over 300 attendees and 900 comments from local behavioral health authorities, nonprofit organizations, providers, community members, and recipients of behavioral health services. 

The regulations proposed today complement other recent actions taken by the Department to combat fraud, waste, and abuse, including:

  • Pausing the introduction of new behavioral health provider types after health officials identified instances of Medicaid fraud, waste, and abuse.
  • Transitioning to a new behavioral health administrative services organization to ensure compliance with federal regulations and to implement continuous quality assurance and improvement evaluations.
  • Reviewing and analyzing the over-utilization of certain service types to assess appropriate and inappropriate usage.
  • Increasing referrals to the Office of the Inspector General and the Attorney General’s Medicaid Fraud and Vulnerable Victims Unit.
Marylanders have until June 16, 2025, to submit public comments on the proposed regulatory changes. They can send comments 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 mdh.regs@maryland.gov. 

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The Maryland Department of Health is dedicated to protecting and improving the health and safety of all Marylanders through disease prevention, access to care, quality management and community engagement. 

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