Health Insurance Carriers and Pharmacy Benefits Managers – Clinician–Administered Drugs and Related Services
Impact
If enacted, HB1368 will significantly change the operational landscape for health insurance companies operating in Maryland. The bill explicitly forbids practices where insurers might deny coverage, impose additional costs, or limit access based on the specific pharmacy from which a clinician-administered drug is obtained. Starting January 1, 2025, all insurance policies and plans within the state will have to adhere to these new guidelines, fostering a more patient-centric approach to obtaining prescribed medications.
Summary
House Bill 1368 addresses the regulations surrounding the dispensation of clinician-administered drugs by health insurance carriers and pharmacy benefits managers. The bill prohibits these entities from imposing certain restrictions and conditions on how these drugs and related services are provided to insured individuals. This legislation seeks to enhance patient access to necessary medications administered by healthcare providers and allows for greater flexibility in choosing where patients can receive these drugs, whether at home infusion sites or other authorized facilities.
Contention
While proponents of HB1368 argue that it bolsters patient rights and enhances the healthcare experience by ensuring necessary treatments are accessible without undue burden, opponents may raise concerns regarding potential implications for insurance costs and the operational security of pharmacy networks. The discussion around this bill is indicative of a larger trend regarding the balance of power between healthcare providers, insurance companies, and patients in making healthcare decisions.
Prohibits healthcare entities from interfering with a patient's right to choose to obtain a clinician-administered drug from their provider or pharmacy of choice.