Bill > SB111

This bill modifies Maryland's medical assistance program and health insurance regulations to improve access to mental health medications by prohibiting certain insurance restrictions. Starting July 1, 2025, the Maryland Medical Assistance Program and health insurers will be prohibited from applying prior authorization requirements or step therapy/fail-first protocols for prescription drugs used to treat specific serious mental health conditions in adult patients, including bipolar disorder, schizophrenia, major depression, post-traumatic stress disorder, and medication-induced movement disorders associated with serious mental illness treatment. The bill defines step therapy as a protocol requiring patients to try specific prescription drugs in a predetermined sequence before an insurer will cover a prescriber's preferred medication. To ensure the policy's financial sustainability, the Maryland Department of Health must report any cost increases to the Medical Assistance Program, and if these increases exceed $2 million annually, the provisions will automatically be nullified. The new regulations will apply to all health insurance policies issued or renewed on or after January 1, 2026, with the goal of reducing barriers to mental health treatment and allowing healthcare providers more flexibility in prescribing medications.

Budget and Finance

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0111?ys=2025RS