Bill > HB1440

This bill prohibits managed care organizations, insurers, nonprofit health service plans, and health maintenance organizations from requiring prior authorization, step therapy, or fail-first protocols for prescription drugs that have been reviewed by the Prescription Drug Affordability Board (PDAB) under certain conditions, specifically if the PDAB has not determined the drug causes affordability challenges, has made a policy recommendation about the drug to the General Assembly, or has set an upper payment limit for the drug. Prior authorization is a process where a healthcare provider must get approval from an insurer before a prescription drug is covered, while step therapy or fail-first protocols require patients to try certain less expensive drugs before a more expensive one is covered. The bill also clarifies what constitutes limiting, restricting, or excluding coverage of a prescription drug, including moving it to a more restrictive tier or removing it from a formulary, with exceptions for drugs with safety concerns or manufacturing discontinuances. These changes are intended to streamline access to prescription drugs that have undergone review by the PDAB, ensuring that patients can more easily obtain medications that the board has assessed.

Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB1440?ys=2026RS