Bill > SB608

This bill mandates that starting July 1, 2027, the Maryland Medical Assistance Program, along with certain health insurers, nonprofit health services plans, and health maintenance organizations (collectively referred to as "carriers" or "entities"), must provide coverage for pharmacogenomic testing, which is laboratory genetic testing used to determine how an individual's genes might affect their response to medications. This coverage is required when a treating provider orders single-gene or multigene pharmacogenomic testing for a patient diagnosed with depression or anxiety, and the provider is considering a medication change, dose adjustment, or augmentation where a known gene-drug interaction exists. The bill also limits prior authorization requirements for this testing, ensuring a clear and timely pathway for coverage, requiring only necessary documentation from the treating provider, allowing sufficient time for submission of requests after specimen collection, permitting either the provider or a laboratory to submit the request, and prohibiting undue administrative burdens or delays. Entities that fail to comply may face monetary penalties and be required to implement corrective action plans.

Budget and Finance

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0608?ys=2026RS