Bill > HB813

This bill requires the Maryland Insurance Administration and the Maryland Department of Health, in collaboration with the Prescription Drug Affordability Board, to establish a comprehensive workgroup to study pharmacy reimbursement and related issues. The workgroup will include diverse stakeholders from the healthcare and pharmaceutical industries, and is tasked with conducting an in-depth review of several key areas: pharmacy benefits management practices, reimbursement structures, specialty drug definitions, ERISA (Employee Retirement Income Security Act) regulatory exemptions, and pharmacy contracting costs. Specifically, the workgroup will examine existing Maryland Medical Assistance Program requirements, compare pharmacy benefits services across different states, analyze potential cost-saving measures, review specialty drug classifications, and investigate current state laws regarding pharmacy benefit managers. The group is required to submit an interim report by December 31, 2025, and a final report by December 31, 2026, to the Senate Finance Committee and the House Health and Government Operations Committee, offering insights and recommendations to potentially improve pharmacy reimbursement and drug pricing transparency. The bill is set to take effect on June 1, 2025, and represents a significant effort to understand and potentially reform pharmacy benefits management practices in Maryland.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0813?ys=2025RS