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HB0808 • 2026

Maryland Medical Assistance Program - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Maryland Medical Assistance Program - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Healthcare
Passed Legislature

This bill passed both chambers and reached final enrollment, even if later executive action is not shown here.

Sponsor
Delegate S. Johnson
Last action
2026-02-19
Official status
In the House - Hearing 2/19 at 1:30 p.m.
Effective date
2026-07-01

Plain English Breakdown

Using official source text because the generated explanation was unavailable or could not be confirmed against the official bill text.

Maryland Medical Assistance Program - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Prohibiting the Maryland Medical Assistance Program from applying a prior authorization requirement in certain circumstances to and from applying a step therapy or fail-first protocol for a prescription drug used to treat an adult enrollee's diagnosis of bipolar disorder, schizophrenia, major depression, post-traumatic stress disorder, or a medication-induced movement disorder associated with the treatment of serious mental illness.

What This Bill Does

  • Prohibiting the Maryland Medical Assistance Program from applying a prior authorization requirement in certain circumstances to and from applying a step therapy or fail-first protocol for a prescription drug used to treat an adult enrollee's diagnosis of bipolar disorder, schizophrenia, major depression, post-traumatic stress disorder, or a medication-induced movement disorder associated with the treatment of serious mental illness.

Limits and Unknowns

  • This entry is temporarily using official source text because the generated explanation could not be confirmed against the official bill text during the last sync.

Bill History

  1. 2026-02-19 House

    Hearing canceled

  2. 2026-02-19 House

    Hearing 2/19 at 1:30 p.m.

  3. 2026-02-04 House

    First Reading Health

  4. 2026-02-04 House

    Hearing 2/19 at 1:00 p.m.

  5. Maryland General Assembly

    Text - First - Maryland Medical Assistance Program - Step Therapy, Fail-First Protocols, and Prior Authorization - Prescription Drugs to Treat Serious Mental Illness

Official Summary Text

Prohibiting the Maryland Medical Assistance Program from applying a prior authorization requirement in certain circumstances to and from applying a step therapy or fail-first protocol for a prescription drug used to treat an adult enrollee's diagnosis of bipolar disorder, schizophrenia, major depression, post-traumatic stress disorder, or a medication-induced movement disorder associated with the treatment of serious mental illness.

Current Bill Text

Read the full stored bill text
EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb0808*

HOUSE BILL 808
J1 6lr3117
CF SB 490
By: Delegate S. Johnson
Introduced and read first time: February 4, 2026
Assigned to: Health

A BILL ENTITLED

AN ACT concerning 1

Maryland Medical Assistance Program – Step Therapy, Fail–First Protocols, and 2
Prior Authorization – Prescription Drugs to Treat Serious Mental Illness 3

FOR the purpose of prohibiting the Maryland Medical Assistance Program from applying 4
a prior authorization requirement in certain circumstances to and from applying a 5
step therapy or fail –first protocol for a prescription drug used to treat an adult 6
enrollee’s diagnosis of bipolar disorder, schizophrenia, major depression, 7
post–traumatic s tress disorder, or a medication –induced movement disorder 8
associated with the treatment of serious mental illness; and generally relating to the 9
Maryland Medical Assistance Program and coverage of drugs to treat serious mental 10
illness. 11

BY adding to 12
Article – Health – General 13
Section 15–160 14
Annotated Code of Maryland 15
(2023 Replacement Volume and 2025 Supplement) 16

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 17
That the Laws of Maryland read as follows: 18

Article – Health – General 19

15–160. 20

(A) IN THIS SECTION, “STEP THERAPY OR FAIL–FIRST PROTOCOL” HAS THE 21
MEANING STATED IN § 15–142 OF THE INSURANCE ARTICLE. 22

2 HOUSE BILL 808

(B) EXCEPT AS REQUIRED UNDER 42 U.S.C. § 1396A, BEGINNING JULY 1, 1
2026, THE PROGRAM MAY NOT APPLY A PRIOR AUTHORIZATION REQUIREMENT FOR 2
A PRESCRIPTION DRUG USED TO TREAT AN ADULT ENROLLEE’S DIAGNOSIS OF: 3

(1) BIPOLAR DISORDER; 4

(2) SCHIZOPHRENIA; 5

(3) MAJOR DEPRESSION; 6

(4) POST–TRAUMATIC STRESS DISORDER; OR 7

(5) A MEDICATION–INDUCED MOVEMENT DIS ORDER ASSOCIATED 8
WITH THE TREATMENT OF A SERIOUS MENTAL ILLNESS. 9

(C) BEGINNING JULY 1, 2026, THE PROGRAM MAY NOT APPLY A STEP 10
THERAPY OR FAIL–FIRST PROTOCOL FOR A PRESCRIPTION DRUG USED TO TREAT AN 11
ENROLLEE’S DIAGNOSIS OF: 12

(1) BIPOLAR DISORDER; 13

(2) SCHIZOPHRENIA; 14

(3) MAJOR DEPRESSION; 15

(4) POST–TRAUMATIC STRESS DISORDER; OR 16

(5) A MEDICATION–INDUCED MOVEMENT DIS ORDER ASSOCIATED 17
WITH THE TREATMENT OF A SERIOUS MENTAL ILLNESS. 18

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 19
1, 2026. It shall remain effective for a period of 3 years and, at the end of June 30, 2029, 20
this Act, with no further action required by the General Assembly, shall be abrogated and 21
of no further force and effect. 22