Maryland Senate Bill SB837

Maryland 2026 Regular Session

• Introduced: 2/6/26
• Refer: 2/6/26

Caption

Maryland Medical Assistance Program and Health Insurance - Coverage and Utilization Review - Drugs Reviewed by the Prescription Drug Affordability Board

Impact

The bill alters existing provisions in state law regarding the coverage and utilization review of prescription drugs. Specifically, it limits the ability of insurers and managed care organizations to impose barriers on access to medications that have been evaluated for affordability by the Prescription Drug Affordability Board. As a result, patients may find it easier to obtain necessary treatments without delays often caused by administrative hurdles.

Summary

Senate Bill 837 aims to enhance access to prescription drugs for Maryland residents by prohibiting managed care organizations and certain insurers from requiring prior authorization or implementing step therapy for drugs reviewed by the Prescription Drug Affordability Board. This legislation is part of an effort to ensure that patients have more direct access to medications deemed essential and affordable, reflecting a broader push for healthcare reform within the state.

Contention

Notably, the bill has generated discussions regarding the balance of cost control and patient access. Proponents argue that the changes will ensure that patients are not unfairly burdened by insurance requirements that delay treatment or lead to higher out-of-pocket costs. However, there may be concerns from insurers about the potential financial implications of widespread access to various prescription drugs without prior approval mechanisms, which they argue help manage costs effectively and ensure the appropriateness of treatment plans.