MD HB1246

Insurers, nonprofit health service plans, and HMOs must count discounts, financial assistance payments, product vouchers, and other third-party payments toward an enrollee's coinsurance, copayment, deductible, and out-of-pocket maximum for covered prescription drugs without generic equivalents or biosimilars

Providers of financial assistance must notify enrollees within 7 days of the maximum dollar amount and expiration date, and must provide the assistance for the entire plan year; violations constitute Consumer Protection Act violations

Health plans are prohibited from setting or altering coverage terms based on the availability or amount of financial or product assistance for a prescription drug, though they may still use rebates in benefit design

The requirements do not apply to the deductible portion of high-deductible health plans (as defined under 26 U.S.C. § 223), and charitable organizations are exempt from the notification requirements

Applies to all policies issued, delivered, or renewed in Maryland on or after January 1, 2026