Sen. Pamela Bridal urges fee schedule for workers’ compensation prescriptions to save counties millions

Sen. Pamela Bridal (D-32) told the House Economic Matters Committee that Senate Bill 306 would require the Maryland Workers' Compensation Commission to adopt a prescription drug fee schedule for workers' compensation by Sept. 1, 2026, and directs the Maryland Prescription Drug Affordability Board (PDAB) to complete a study by March 1, 2026, to inform that schedule. Bridal cited data showing wide price differences between billed pharmacy amounts and acquisition-cost benchmarks and said a fee guide could save counties and self-insured employers millions.

Bridal said the bill does not prescribe a single index and specifically excludes use of Average Wholesale Price (AWP), which she called an unreliable benchmark. The legislation lets the commission choose acquisition-based measures — e.g., NADAC, WAC/AAC or other acquisition-cost indexes — and to apply an added dispensing fee or percentage so pharmacies can earn a reasonable profit.

County and municipal representatives, Chesapeake Employers Insurance (the largest workers' compensation carrier in Maryland), the Maryland Association of Counties and the Maryland Municipal League supported the bill in testimony. Chesapeake Employers' Carmine D’Alessandro told the committee the proposal aligns with changes the Maryland Medicaid program made years earlier and cited Pennsylvania court rulings rejecting AWP. Carrington Anderson of the Maryland Association of County said Prince George’s County paid about $10.2 million for prescriptions in 2023–24 while acquisition-cost data in Bridal’s packet showed an estimated market acquisition price near $2.5 million for the same fills.

Pharmacies and pharmacy advocates opposed limiting the commission to acquisition-only approaches. Home‑delivery pharmacies and pharmacy representatives urged the committee to allow the commission to evaluate multiple reimbursement models, including AWP or blended approaches, arguing acquisition-only rates may not cover operating and dispensing costs—particularly for smaller community pharmacies. Rescue Meds and other home-delivery pharmacies said carve-outs for pharmacy benefit manager (PBM) arrangements and remaining litigation risk could reduce injured workers’ pharmacy access. Several injured workers and public‑safety employees described delays and denials they said were solved only by independent, local pharmacies.

Proponents said the bill preserves access to prescriptions for injured workers, does not remove pharmacies from providing medication, and does not limit clinicians’ ability to prescribe specific drugs. Witnesses from defense counsel and the Maryland Defense Council said a fee schedule would bring prescription reimbursement under the same kind of fee-guideline regime that already governs other medical services in workers’ compensation.

No committee vote on SB 306 is recorded in the transcript. Bridal noted the bill passed the Senate 47–0 and asked the committee for a favorable report to send the measure forward.

Ending: Supporters and opponents urged that the Workers’ Compensation Commission be given sufficient time and stakeholder data to adopt a durable fee guide. The bill tasks the PDAB with a targeted study and sets a Sept. 1, 2026, deadline for the commission’s fee schedule recommendation.