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Senate Bill 773 restricts pharmacy benefits managers from manipulating health plan coverage

March 11, 2025 | Senate Bills (Introduced), 2025 Bills, Maryland Legislation Bills Collections, Maryland


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Senate Bill 773 restricts pharmacy benefits managers from manipulating health plan coverage
Maryland's Senate Bill 773 is poised to reshape the landscape of prescription drug coverage, aiming to enhance transparency and accessibility for patients. Introduced on March 11, 2025, the bill prohibits pharmacy benefits managers from manipulating health benefit plan terms based on financial assistance information for prescription drugs. This move seeks to protect patients from potential discrimination in drug coverage based on their financial support options.

Key provisions of the bill mandate that any third party providing financial assistance for out-of-pocket prescription costs must inform enrollees within seven days about the total assistance available and its duration. Furthermore, this assistance cannot be tied to enrollment in specific health plans, ensuring that patients have the freedom to choose their coverage without undue pressure.

The bill has sparked notable discussions among lawmakers and healthcare advocates, with supporters arguing it will empower patients and promote fair access to necessary medications. Critics, however, express concerns about the potential impact on pharmacy benefits managers and the overall healthcare market, fearing it could lead to increased costs for insurers and, ultimately, consumers.

As the bill is set to take effect on January 1, 2026, its implications could be significant, potentially setting a precedent for similar legislation in other states. Experts suggest that if successful, Senate Bill 773 could lead to a more equitable healthcare system, where patients are less burdened by the complexities of financial assistance and more focused on their health needs. The coming months will be crucial as stakeholders prepare for the changes ahead and assess the bill's long-term effects on Maryland's healthcare landscape.

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Scribe from Workplace AI
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