Bill > SB608

This bill mandates that the Maryland Medical Assistance Program and certain health insurance providers, including nonprofit health services plans and health maintenance organizations (HMOs), must cover 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 for single-gene and multigene tests when ordered by a treating provider for patients diagnosed with depression or anxiety, provided the testing is intended to guide medication selection, dosing, or management, or if the provider is considering a medication change due to known gene-drug interactions, and if there's evidence of a clinically meaningful impact on drug efficacy or safety, consistent with accepted medical standards and approved by the FDA, and covered by Medicare. The bill also limits prior authorization requirements for this testing, ensuring a clear pathway for coverage, requiring only necessary documentation, allowing sufficient time for submissions, permitting requests from providers or laboratories, and prohibiting undue burdens or delays. The bill takes effect January 1, 2027, and applies to policies, contracts, and health benefit plans issued, delivered, or renewed on or after that date.