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

SB 111 prohibits Maryland's Medicaid program (Maryland Medical Assistance Program) and certain health insurers from requiring prior approval (prior authorization) or step therapy/fail-first protocols for prescription drugs treating five specific serious mental illnesses: bipolar disorder, schizophrenia, major depression, PTSD, and medication-induced movement disorders linked to mental illness treatment. It applies to all Medicaid enrollees and individuals covered under the affected health plans starting July 1, 2025. The bill directly affects patients seeking these mental health medications by removing barriers that previously forced them to try alternative treatments first or get extra approvals. This change ensures coverage for prescribed treatments without unnecessary delays for these specific conditions.