Maryland 2024 Regular Session

Maryland Senate Bill SB990

Introduced
2/2/24  

Caption

Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Impact

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.

Summary

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.

Contention

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.

Companion Bills

MD HB1423

Crossfiled Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Previously Filed As

MD HB785

Health Insurance - Step Therapy or Fail-First Protocol and Prior Authorization - Revisions

MD SB515

Health Insurance – Step Therapy or Fail–First Protocol – Revisions

MD SB75

Insurance and Maryland Medical Assistance Program – Treatment of Alopecia Areata – Coverage Requirements

MD HB813

Maryland Medical Assistance Program – Prescription Digital Therapeutics

MD SB441

Maryland Medical Assistance Program - Prescription Digital Therapeutics

MD HB1217

Maryland Medical Assistance Program and Health Insurance - Required Coverage for Biomarker Testing

MD SB805

Maryland Medical Assistance Program and Health Insurance – Required Coverage for Biomarker Testing

MD HB1199

Health Insurance - Lyme Disease and Related Tick-Borne Illnesses - Long-Term Antibiotic Treatment

MD HB283

Maryland Medical Assistance Program - Gender-Affirming Treatment (Trans Health Equity Act)

MD HB382

Maryland Department of Health and Prescription Drug Affordability Board - Managed Care Organizations and Prescription Drug Claims - Study

Similar Bills

MD HB382

Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription to Treat Serious Mental Illness

MD SB111

Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription to Treat Serious Mental Illness

MD HB1423

Maryland Medical Assistance Program and Health Insurance - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

MD SB515

Health Insurance – Step Therapy or Fail–First Protocol – Revisions

MD SB921

Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer

MD HB1087

Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer

MD HB785

Health Insurance - Step Therapy or Fail-First Protocol and Prior Authorization - Revisions

MD SB974

Maryland Medical Assistance Program and Health Insurance - Nonopioid Drugs for the Treatment of Pain