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Committee advances bill expanding Prescription Drug Affordability Board authority to consider upper payment limits, adds Medicaid consultation requirement
Summary
The Health and Government Operations Committee voted to advance House Bill 424, giving the Prescription Drug Affordability Board discretion to pursue upper payment limits for prescription drugs in Maryland and requiring the board to consult with Medicaid before setting limits that may affect the program.
The Health and Government Operations Committee on Friday voted to advance House Bill 424, which would expand the Prescription Drug Affordability Board’s (PDAB) authority to determine whether to set upper payment limits (UPLs) for purchases and payer reimbursements of prescription drugs in Maryland and to establish a specified process for setting those limits.
The bill, described by committee staff, removes certain existing reporting requirements about UPLs, authorizes (rather than mandates) an expansion of UPL authority, and adds new authority for the board to reconsider a UPL when a drug becomes the subject of a current shortage. Staff explained that the expansion would not apply to certain federal programs and that the bill corrects typographical errors and aligns contingency dates in the statute.
A set of amendments requires the PDAB to consult with Medicaid before setting UPLs that may impact Medicaid and clarifies that the authority to set UPLs would not apply to purchases or payer reimbursements related to specified federal programs. Elliot Allison, speaking to the committee, stressed that UPLs are one of several cost‑containment tools under consideration and said the board is exploring options including manufacturer engagement. "Upper payment limits is just one possible tool," Allison said, and the board is looking at all cost containment options available to them.
Supporters framed the bill as a step to contain rising prescription drug costs that contribute to premiums and out‑of‑pocket costs; opponents expressed ideological concerns that price controls could ration medication. The transcript records a group of delegates who registered opposition during the vote: "Delegate Shaliga, Delegate Chisholm, Delegate Morgan, Delegate Riley, Delegate Hutchinson, Delegate Kipke." The committee adopted the amendments and passed the bill as amended.
The committee record shows the amendment was moved and seconded, discussion occurred, and the bill passed on the committee floor with named oppositions recorded. The bill’s expansion of UPL authority is contingent on preconditions described in the bill text; committee staff summarized those preconditions in the packet but did not provide an exhaustive statutory citation in the hearing.
