| Old | New | Differences | |
|---|---|---|---|
| 1 | 1 | ||
| 2 | 2 | ||
| 3 | 3 | EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW. | |
| 4 | 4 | [Brackets] indicate matter deleted from existing law. | |
| 5 | - | Underlining indicates amendments to bill. | |
| 6 | - | Strike out indicates matter stricken from the bill by amendment or deleted from the law by | |
| 7 | - | amendment. | |
| 8 | 5 | *sb0306* | |
| 9 | 6 | ||
| 10 | 7 | SENATE BILL 306 | |
| 11 | 8 | K1 5lr0818 | |
| 12 | 9 | ||
| 13 | 10 | By: Senator Beidle | |
| 14 | 11 | Introduced and read first time: January 13, 2025 | |
| 15 | 12 | Assigned to: Finance | |
| 16 | - | Committee Report: Favorable with amendments | |
| 17 | - | Senate action: Adopted | |
| 18 | - | Read second time: February 22, 2025 | |
| 19 | 13 | ||
| 20 | - | ||
| 14 | + | A BILL ENTITLED | |
| 21 | 15 | ||
| 22 | 16 | AN ACT concerning 1 | |
| 23 | 17 | ||
| 24 | 18 | Workers’ Compensation – Prescription Drug and Pharmaceutical Services – 2 | |
| 25 | 19 | Reimbursements 3 | |
| 26 | 20 | ||
| 27 | 21 | FOR the purpose of requiring the State Workers’ Compensation Commission to regulate 4 | |
| 28 | 22 | fees and other charges for the reimbursement of prescription drugs and 5 | |
| 29 | - | pharmaceutical services under certain circumstances; limiting reimbursements to a 6 | |
| 30 | - | certain cost index or indexes; requiring the Maryland Prescription Drug Affordability 7 | |
| 31 | - | Board to conduct a certain study; and generally relating to reimbursement for 8 | |
| 32 | - | prescription drugs and pharmaceutical services under workers’ compensation law. 9 | |
| 23 | + | pharmaceutical services; limiting reimbursements to a certain cost index or indexes; 6 | |
| 24 | + | and generally relating to reimbursement for prescription drugs and pharmaceutical 7 | |
| 25 | + | services under workers’ compensation law. 8 | |
| 33 | 26 | ||
| 34 | - | BY repealing and reenacting, with amendments, | |
| 35 | - | Article – Labor and Employment | |
| 36 | - | Section 9–663 | |
| 37 | - | Annotated Code of Maryland | |
| 38 | - | (2016 Replacement Volume and 2024 Supplement) | |
| 27 | + | BY repealing and reenacting, with amendments, 9 | |
| 28 | + | Article – Labor and Employment 10 | |
| 29 | + | Section 9–663 11 | |
| 30 | + | Annotated Code of Maryland 12 | |
| 31 | + | (2016 Replacement Volume and 2024 Supplement) 13 | |
| 39 | 32 | ||
| 40 | - | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, | |
| 41 | - | That the Laws of Maryland read as follows: | |
| 33 | + | SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 14 | |
| 34 | + | That the Laws of Maryland read as follows: 15 | |
| 42 | 35 | ||
| 43 | - | Article – Labor and Employment | |
| 36 | + | Article – Labor and Employment 16 | |
| 44 | 37 | ||
| 45 | - | 9–663. | |
| 38 | + | 9–663. 17 | |
| 46 | 39 | ||
| 47 | - | (a) (1) The Commission shall adopt regulations setting standards for the 19 | |
| 48 | - | assessment of fines under § 9–664 of this Part IX of this subtitle. 20 2 SENATE BILL 306 | |
| 40 | + | (a) (1) The Commission shall adopt regulations setting standards for the 18 | |
| 41 | + | assessment of fines under § 9–664 of this Part IX of this subtitle. 19 | |
| 42 | + | ||
| 43 | + | (2) The Commission may adopt regulations about: 20 | |
| 44 | + | ||
| 45 | + | (i) the provision of medicine and medical, nursing, and hospital 21 | |
| 46 | + | services to a covered employee; 22 | |
| 47 | + | ||
| 48 | + | (ii) payment for the medicine and services; and 23 2 SENATE BILL 306 | |
| 49 | 49 | ||
| 50 | 50 | ||
| 51 | 51 | ||
| 52 | - | (2) The Commission may adopt regulations about: 1 | |
| 52 | + | (iii) the exercise by the Chairman of the Commission of the powers 1 | |
| 53 | + | granted under § 9–662 of this subtitle. 2 | |
| 53 | 54 | ||
| 54 | - | ( | |
| 55 | - | services | |
| 55 | + | (b) (1) The Commission may regulate fees and other charges for medical 3 | |
| 56 | + | services or treatment under this subtitle. 4 | |
| 56 | 57 | ||
| 57 | - | (ii) payment for the medicine and services; and 4 | |
| 58 | + | (2) (I) THE COMMISSION SHALL REGU LATE FEES AND OTHER 5 | |
| 59 | + | CHARGES FOR THE REIM BURSEMENT OF PRESCRI PTION DRUGS AND 6 | |
| 60 | + | PHARMACEUTICAL SERVI CES UNDER THIS SUBTITLE. 7 | |
| 58 | 61 | ||
| 59 | - | (iii) the exercise by the Chairman of the Commission of the powers 5 | |
| 60 | - | granted under § 9–662 of this subtitle. 6 | |
| 62 | + | (II) REIMBURSEMENT UNDER S UBPARAGRAPH (I) OF THIS 8 | |
| 63 | + | PARAGRAPH SHALL BE L IMITED TO AN INDEX OR INDEXES BASED ON ACQUISITION 9 | |
| 64 | + | COST, CALCULATED ON A PER UNIT BASIS, AS OF THE DATE OF DI SPENSING AND MAY 10 | |
| 65 | + | INCLUDE REASONABLE D ISPENSING FEES. 11 | |
| 61 | 66 | ||
| 62 | - | (b) (1) The Commission may regulate fees and other charges for medical 7 | |
| 63 | - | services or treatment under this subtitle. 8 | |
| 67 | + | (3) Each fee or other charge for medical service or treatment under this 12 | |
| 68 | + | subtitle is limited to the amount that prevails in the same community for similar treatment 13 | |
| 69 | + | of an injured individual with a standard of living that is comparable to that of the covered 14 | |
| 70 | + | employee. 15 | |
| 64 | 71 | ||
| 65 | - | (2) (I) THE NOT LATER THAN SEPTEMBER 1, 2026, THE 9 | |
| 66 | - | COMMISSION SHALL REGU LATE FEES AND OTHER CHARGES FOR THE 10 | |
| 67 | - | REIMBURSEMENT OF PRE SCRIPTION DRUGS AND PHARMAC EUTICAL SERVICES 11 | |
| 68 | - | UNDER THIS SUBTITLE PROVIDED BY A PERSON WHO HOLDS A PHARMACY PERMIT 12 | |
| 69 | - | UNDER TITLE 12, SUBTITLE 4 OF THE HEALTH OCCUPATIONS ARTICLE. 13 | |
| 72 | + | [(3)] (4) At least once every 2 years, the Commission shall: 16 | |
| 70 | 73 | ||
| 71 | - | (II) REIMBURSEMENT UNDER S UBPARAGRAPH (I) OF THIS 14 | |
| 72 | - | PARAGRAPH SHALL BE L IMITED TO AN INDEX O R INDEXES BASE D ON ACQUISITION 15 | |
| 73 | - | COST, CALCULATED ON A PER UNIT BASIS, AS OF THE DATE OF DI SPENSING AND MAY 16 | |
| 74 | - | INCLUDE: 17 | |
| 74 | + | (i) review its guide of medical and surgical fees for completeness and 17 | |
| 75 | + | reasonableness; and 18 | |
| 75 | 76 | ||
| 76 | - | 1. REASONABLE DISPENSIN G FEES; AND 18 | |
| 77 | + | (ii) make appropriate revisions to the guide of medical and surgical 19 | |
| 78 | + | fees. 20 | |
| 77 | 79 | ||
| 78 | - | 2. ANY OTHER PERCENTAGE INCREASE OR DECREASE 19 | |
| 79 | - | DETERMINED BY THE COMMISSION. 20 | |
| 80 | - | ||
| 81 | - | (III) THIS PARAGRAPH DOES N OT PROHIBIT AN INSUR ANCE 21 | |
| 82 | - | CARRIER OR EMPLOYER FROM CONTRACTING WIT H A PHARMACY BENEFIT S 22 | |
| 83 | - | MANAGER, A NETWORK OF PHARMAC IES, OR DISPENSING PROVID ERS: 23 | |
| 84 | - | ||
| 85 | - | 1. FOR REIMBURSEMENT RA TES DIFFERENT THAN 24 | |
| 86 | - | THOSE ESTABLISHED BY THE COMMISSION; OR 25 | |
| 87 | - | ||
| 88 | - | 2. TO USE A PRICING IND EX OR INDEXES DIFFER ENT 26 | |
| 89 | - | THAN THOSE SELECTED BY THE COMMISSION. 27 | |
| 90 | - | ||
| 91 | - | (3) Each fee or other charge for medical service or treatment under this 28 | |
| 92 | - | subtitle is limited to the amount that prevails in the same community for similar treatment 29 | |
| 93 | - | of an injured individual with a standard of living that is comparable to that of the covered 30 | |
| 94 | - | employee. 31 | |
| 95 | - | SENATE BILL 306 3 | |
| 96 | - | ||
| 97 | - | ||
| 98 | - | [(3)] (4) At least once every 2 years, the Commission shall: 1 | |
| 99 | - | ||
| 100 | - | (i) review its guide of medical and surgical fees for completeness and 2 | |
| 101 | - | reasonableness; and 3 | |
| 102 | - | ||
| 103 | - | (ii) make appropriate revisions to the guide of medical and surgical 4 | |
| 104 | - | fees. 5 | |
| 105 | - | ||
| 106 | - | SECTION 2. AND BE IT FURTHER ENACTED, That: 6 | |
| 107 | - | ||
| 108 | - | (a) The Maryland Prescription Drug Affordability Board: 7 | |
| 109 | - | ||
| 110 | - | (1) shall conduct a study on prescription drug affordability challenges 8 | |
| 111 | - | related to workers’ compensation claims that includes: 9 | |
| 112 | - | ||
| 113 | - | (i) an overview of prescription drug prescribing and billing practices 10 | |
| 114 | - | and trends that are specialized to the workers’ compensation market; 11 | |
| 115 | - | ||
| 116 | - | (ii) research into specific prescribing, billing, and dispensing 12 | |
| 117 | - | practices, including: 13 | |
| 118 | - | ||
| 119 | - | 1. prescribing high cost formulations and compounded 14 | |
| 120 | - | formulations of commonly available drugs; 15 | |
| 121 | - | ||
| 122 | - | 2. billing and dispensing from entities that do not bill or 16 | |
| 123 | - | provide services in the health insurance market; and 17 | |
| 124 | - | ||
| 125 | - | 3. billing practices using billing codes without standardized 18 | |
| 126 | - | pricing metrics; and 19 | |
| 127 | - | ||
| 128 | - | (iii) making recommendations, if applicable, for policies to address 20 | |
| 129 | - | identified affordability challenges; and 21 | |
| 130 | - | ||
| 131 | - | (2) may require, subject to applicable federal and State laws, entities that 22 | |
| 132 | - | pay, prescribe, bill, and dispense prescription drugs under workers’ compensation claims 23 | |
| 133 | - | to report information to the Board as necessary to complete the study. 24 | |
| 134 | - | ||
| 135 | - | (b) On or before March 1, 2026, the Prescription Drug Affordability Board shall 25 | |
| 136 | - | report its findings and any recommendations to the Senate Finance Committee and the 26 | |
| 137 | - | House Economic Matters Committee, in accordance with § 2–1257 of the State Government 27 | |
| 138 | - | Article. 28 | |
| 139 | - | ||
| 140 | - | SECTION 2. 3. AND BE IT FURTHE R ENACTED, That this Act shall take effect 29 | |
| 141 | - | October July 1, 2025. 30 | |
| 142 | - | ||
| 80 | + | SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 21 | |
| 81 | + | October 1, 2025. 22 |