MD HB659

Prohibits health insurance carriers from imposing prior authorization, step therapy, or quantity limit requirements on eligible providers for health care services included in two-sided incentive arrangements

Two-sided incentive arrangements are contracts where providers can earn incentives for meeting cost targets but also face potential fund recoupment if costs exceed targets (capped at 10% of annual payments)

Eligible providers include licensed physicians and sets of health care practitioners (group practices, accountable care organizations, clinically integrated networks) who voluntarily participate in these arrangements

Applies to insurers, nonprofit health service plans, and health maintenance organizations providing hospital, medical, or surgical benefits in Maryland

Takes effect January 1, 2026, applying to all policies, contracts, and health benefit plans issued, delivered, or renewed on or after that date