Health Benefit Plans - Calculation of Cost-Sharing Contribution - Requirements

HB 1246 requires Maryland health insurers, nonprofit health plans, and health maintenance organizations to include certain patient discounts, financial assistance, product vouchers, or out-of-pocket expenses paid for prescription drugs when calculating cost-sharing (like copays or deductibles). This applies to covered drugs without a preferred generic equivalent or where prior authorization was needed, but excludes high-deductible health plans. The bill also mandates that providers notifying insureds about the maximum value and expiration date of these discounts. It takes effect January 1, 2026, for all health plans issued or renewed in Maryland after that date. The law directly affects Maryland residents using prescription drug coverage under these health plans.