On March 28, 2025, the Maryland Legislature introduced Senate Bill 975, a significant piece of legislation aimed at reforming the practices of pharmacy benefits managers (PBMs) in the state. This bill seeks to address concerns regarding transparency and fairness in the reimbursement processes for pharmacies, particularly in relation to specialty drugs.

The primary purpose of Senate Bill 975 is to prevent PBMs from engaging in practices that could lead to conflicts of interest or unfair competition. Specifically, the bill prohibits PBMs from reimbursing themselves or their affiliates at a higher rate than they reimburse independent pharmacies for the same pharmaceutical products or services. This provision aims to level the playing field for local pharmacies, ensuring they can compete fairly in the marketplace.

Key provisions of the bill include restrictions on PBMs requiring beneficiaries to use specific pharmacies for specialty drugs, unless certain conditions are met. Additionally, the bill outlines that it will apply to all health benefit plans issued or renewed in Maryland starting January 1, 2026, giving stakeholders time to adjust to the new regulations.

The introduction of Senate Bill 975 has sparked notable debates among lawmakers, healthcare providers, and pharmacy representatives. Supporters argue that the bill is essential for protecting small pharmacies from being undercut by larger corporate entities, which can leverage their size to negotiate better reimbursement rates. Critics, however, express concerns that the bill may lead to increased costs for consumers and insurance providers, potentially impacting the availability of certain medications.

The implications of this legislation are significant. If passed, it could reshape the landscape of pharmacy benefits management in Maryland, potentially leading to lower costs for consumers and a more equitable environment for independent pharmacies. Experts suggest that the bill could serve as a model for other states grappling with similar issues related to PBM practices.

As the legislative session progresses, stakeholders will be closely monitoring the discussions surrounding Senate Bill 975, which could have lasting effects on the healthcare system in Maryland and beyond. The outcome of this bill may not only influence local pharmacies but also set a precedent for how pharmacy benefits are managed across the nation.