Bill > HB321

This bill modifies Maryland's insurance law regarding pharmacy benefits managers (PBMs) by altering the definition of "purchaser" to exclude certain nonprofit health maintenance organizations (HMOs). Specifically, the bill exempts nonprofit HMOs that operate as a group model, provide services solely to their own members, and furnish services through their internal pharmacy operations from being classified as a "purchaser" under the law. The bill removes previous language that limited certain provisions of the law to PBMs providing services on behalf of a carrier, effectively expanding the applicability of PBM regulations. Additionally, the bill requires the Maryland Insurance Administration to convene a workgroup by January 1, 2026, to review and make recommendations on existing laws related to PBMs, specialty pharmacies, and anti-steering practices. The workgroup will examine specific sections of the Insurance Article concerning specialty drug coverage, pharmacy usage requirements, and reimbursement, and must report its findings and potential legislative recommendations to the Senate Finance Committee and the House Health and Government Operations Committee. The bill will take effect on June 1, 2025, with some provisions becoming effective on January 1, 2026.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0321?ys=2025RS