MD HB1440

Prohibits managed care organizations, insurers, nonprofit health service plans, and HMOs from requiring prior authorization or step therapy for prescription drugs reviewed by the Prescription Drug Affordability Board when the Board has not found an affordability challenge, has made a policy recommendation to the General Assembly, or has set an upper payment limit

Bars these entities from limiting, restricting, or excluding coverage of Board-reviewed drugs on their formularies, including reducing maximum coverage, increasing cost sharing, moving drugs to more restrictive tiers, or removing drugs from formularies

Allows exceptions for formulary removal only when the FDA has issued a statement questioning the drug's clinical safety or the manufacturer has notified the FDA of a manufacturing discontinuance

Applies to policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2027

Takes effect July 1, 2026, with insurance-related provisions taking effect January 1, 2027