MD SB961

Requires Maryland Medicaid, health insurers, nonprofit health service plans, and HMOs to cover single-gene and multigene pharmacogenomic testing beginning July 1, 2026

Coverage applies when a treating provider orders testing for a patient diagnosed with depression or anxiety who is being considered for a medication change, dose adjustment, or augmentation involving a drug with a known gene-drug interaction

Prior authorization requirements must provide a clear pathway to coverage, require only minimum necessary documentation, allow sufficient time after specimen collection, and permit submissions by either treating providers or laboratories

Noncompliance penalties include up to $10,000 per instance plus $1,000 per day for continued violations after notification, with corrective action plans required within 30 days

The Insurance Commissioner and Department of Health must conduct periodic compliance audits and establish processes for patients, prescribers, and laboratories to report violations