MD SB475

Prohibits health insurers, HMOs, and nonprofit health service plans 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 by carriers if targets are exceeded

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

Applies to all health insurance policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2026

Takes effect January 1, 2026