Maryland Medical Assistance Program and Health Insurance - Coverage and Utilization Review - Drugs Reviewed by the Prescription Drug Affordability Board

SB 837 prohibits Maryland insurance companies, health plans, and managed care organizations from requiring prior authorization, step therapy, or coverage restrictions for prescription drugs reviewed by the Prescription Drug Affordability Board (PDAB). It specifically blocks these requirements if the PDAB has not determined the drug causes an affordability challenge, has made a policy recommendation about it, or has set an upper payment limit. The bill directly affects patients needing covered medications and insurers that must comply with these new coverage rules. It aims to streamline access to PDAB-reviewed drugs by removing common insurance barriers without altering the drugs' clinical use.