Prince George’s County Special Education Service Delivery, Transparency, and Accountability Act
Summary
HB1013 would require Maryland’s Medicaid program and certain private health coverage arrangements to treat FDA-approved nonopioid pain medications more comparably to opioid or narcotic pain drugs. The bill prohibits the Maryland Medical Assistance Program, insurers, nonprofit health service plans, health maintenance organizations, and managed care organizations from imposing a prior authorization, step therapy, or fail-first protocol on a nonopioid pain drug that is more restrictive than the utilization management applied to an opioid or narcotic pain drug used for the same purpose.
The bill also requires coverage of FDA-approved nonopioid pain drugs to the same extent as covered opioid or narcotic pain drugs. In addition, by December 1, 2026, affected carriers and HMOs must submit a plan to the Maryland Insurance Administration describing how they will provide adequate access to a broad range of pain management services, including nonopioid and nonpharmacologic alternatives, and the Administration must review those plans for compliance and for policies that may unduly favor opioids.
Impact
HB1013 would amend the Maryland Health – General and Insurance Articles to create new parity requirements for pain-treatment drug coverage. It adds new provisions governing Medicaid and private carriers, including a new Insurance Article section specifically addressing nonopioid pain medications, and extends those requirements to managed care organizations beginning July 1, 2026. The bill would affect insurers, nonprofit health service plans, HMOs, managed care organizations, pharmacy benefit managers, and the Maryland Medical Assistance Program by limiting coverage restrictions and requiring comparable access to nonopioid pain treatment options.
Sentiment
The bill’s structure suggests a generally supportive policy goal: expanding access to nonopioid pain treatment and reducing barriers to alternatives to opioids. No committee testimony or recorded votes were provided, so there is no direct evidence of opposition or amendment activity in the available context. Based on the text alone, the measure appears framed as a public-health and opioid-alternatives initiative rather than a controversial coverage expansion.
Contention
The main policy issue is utilization management. The bill restricts prior authorization, step therapy, and fail-first protocols for nonopioid pain drugs unless those restrictions are no more burdensome than the ones applied to opioid or narcotic pain drugs. Another possible point of contention is the required review of carrier plans for signs of “unduly preferential coverage” of opioids, which could raise concerns among insurers and pharmacy benefit managers about administrative burden, compliance costs, and limits on formulary management. Supporters would likely emphasize patient access and opioid-sparing treatment, while opponents may focus on cost control and medical management flexibility.