MD HB813

Maryland Insurance Administration and Department of Health must convene a workgroup with pharmacies, insurers, drug manufacturers, pharmacy benefits managers, and other stakeholders to study pharmacy benefits manager practices in consultation with the Prescription Drug Affordability Board

Workgroup will review pharmacist reimbursement requirements, specialty drug coverage definitions, ERISA exemptions for PBM regulation following the Rutledge v. PCMA decision, and pharmacy contracting costs between commercial plans and Maryland Medical Assistance Program

Study will examine how other states (Ohio, Kentucky, New York, California, West Virginia) operate pharmacy benefits services in Medicaid and strategies for adopting pharmacy reimbursement parity and drug pricing transparency

Interim report due to Senate Finance Committee and House Health and Government Operations Committee by December 31, 2025, with final report due by December 31, 2026

Act takes effect June 1, 2025; approved by Governor Wes Moore on May 20, 2025