Bill > HB1469

This bill requires the Maryland Insurance Administration to establish a workgroup by July 1, 2026, to study the current definition of "specialty drug," which refers to high-cost, often complex medications. This workgroup will include representatives from various groups such as pharmacy benefit managers (companies that manage prescription drug benefits for health plans), independent pharmacists, insurance carriers (both those that own pharmacy benefit managers and those that don't), managed care organizations (health plans that provide medical services), hospitals, and other healthcare providers. The workgroup's task is to analyze how the current definition benefits or disadvantages different stakeholders, how it's applied, its impact on patients, and any unintended consequences, while also comparing it to definitions used in federal, other states', and international laws. By January 1, 2027, the workgroup must submit a recommendation for a new definition of specialty drug that best serves patients and all stakeholders in Maryland, after which this act will expire on June 30, 2027.