Maryland Senate Bill SB111

Maryland 2025 Regular Session

• Introduced: 1/8/24
• Introduced: 1/8/25
• Refer: 1/8/24
• Refer: 1/8/25

Caption

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

Impact

If enacted, SB111 will significantly alter the landscape of mental health treatment access in Maryland. The acceptance of prescription medications without prior authorization or the application of step therapy protocols is expected to facilitate quicker treatment responses for individuals suffering from severe mental health conditions. This legislative change is a response to ongoing concerns regarding the barriers to mental health care imposed by insurance plans, notably those that complicate access to necessary pharmaceuticals.

Summary

Senate Bill 111 aims to reform the Maryland Medical Assistance Program and related health insurance policies by prohibiting the use of prior authorization requirements and step therapy protocols for certain prescription drugs utilized in the treatment of serious mental illnesses. Specifically, the bill targets conditions such as bipolar disorder, schizophrenia, major depression, and post-traumatic stress disorder, ensuring that these treatments are readily accessible to those in need without unnecessary bureaucratic hurdles.

Contention

The proposed legislation may raise points of contention among various stakeholders, including insurance companies and healthcare providers. Critics might argue that eliminating prior authorization and step therapy protocols could lead to increased costs for insurers and potentially support the overprescribing of medications without due diligence. Advocates for mental health rights, however, maintain that the bill is an essential step toward eliminating impediments to timely treatment, thus improving overall mental health outcomes.