Maryland Medical Assistance Program - State Pharmacy Benefits Manager

HB 1384 requires Maryland’s Department of Health to select and contract with a single State Pharmacy Benefits Manager (SPBM) by July 1, 2028. This SPBM will administer pharmacy benefits for all Medicaid recipients, including those enrolled in managed care plans, which must contract with and use the SPBM for all pharmacy services after that date. The bill prohibits "spread pricing" (where managers profit from price differences between pharmacies and the program) and mandates transparent pricing for drug costs, rebates, and fees. It directly affects Medicaid beneficiaries, managed care organizations, and pharmacies by centralizing pharmacy benefit management under state oversight.