Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness
If enacted, SB990 will significantly alter the landscape of mental health treatment in Maryland by ensuring that patients can receive prescribed medications without being subjected to prior authorization requests that might delay their treatment. It aims to improve the overall care for individuals diagnosed with serious mental illnesses by allowing healthcare providers to focus on immediate patient needs rather than navigating bureaucratic insurance processes that could hinder timely access to necessary medications.
Senate Bill 990 addresses the regulations surrounding the Maryland Medical Assistance Program and insurance companies’ application of prior authorization requirements, step therapy, and fail-first protocols for prescription drugs specifically used to treat serious mental illnesses. Effective July 1, 2024, the bill prohibits these entities from applying such protocols for drugs prescribed for conditions like bipolar disorder, schizophrenia, major depression, post-traumatic stress disorder, and medication-induced movement disorders. The intent of the legislation is to streamline access to critical mental health medications without unnecessary barriers that could delay treatment for patients in need.
Debate surrounding SB990 may arise from concerns regarding the potential financial impact on the Maryland Medical Assistance Program. As the bill will come into effect, the Maryland Department of Health is tasked with reporting any cost increases associated with the law implementation up to 2026. If the program experiences a cost increase exceeding $2,000,000 over a certain period, the provisions of the bill may be abrogated, which indicates apprehension among some legislators that the solution may inadvertently lead to significant expenditures that might strain state resources.