Maryland Medical Assistance Program - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

SB 490 prohibits Maryland's Medicaid program (Maryland Medical Assistance Program) from requiring prior authorization or step therapy protocols for prescription drugs treating specific serious mental illnesses. It directly affects Medicaid enrollees diagnosed with bipolar disorder, schizophrenia, major depression, PTSD, or medication-induced movement disorders linked to mental illness treatment. The law, effective July 1, 2026, removes barriers that previously forced doctors to seek approval before prescribing these medications or require trying less effective treatments first. The policy change applies only to these five conditions and expires automatically on June 30, 2029.