Health Insurance - Workgroup to Study the Definition of Specialty Drug

HB 1469 requires Maryland’s Insurance Administration to create a workgroup to study the current definition of "specialty drug" in health insurance. The workgroup, including pharmacy benefits managers, pharmacists, insurers, hospitals, and healthcare providers, will examine how the definition impacts patients and stakeholders, compare it to federal and state standards, and recommend a revised definition. It must submit findings and recommendations to the Governor and legislature by January 1, 2027, after which the bill expires on June 30, 2027. This bill directly affects health insurers, pharmacies, hospitals, and patients using high-cost specialty drugs, aiming to clarify definitions that influence coverage and costs.