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SB 840

SB 840 - This act provides that when calculating an enrollee's overall contribution to an out-of-pocket max or any cost-sharing requirement under a health benefit plan, a health carrier or pharmacy benefits manager shall include any amounts paid by the enrollee or paid on behalf of the enrollee for any medication for which a generic substitute is not available. Additionally, no health carrier or pharmacy benefits manager shall design benefits in a manner that takes into account the availability of any cost-sharing assistance program for any medication for which a generic drug substitute is not available. The provisions of this act shall apply to health benefit plans entered into, amended, extended, or renewed on or after August 28, 2026. This act is identical to SB 1448 (2026), SB 1327 (2026), HB 2279 (2026), HB 1941 (2026), HB 1681 (2026), HB 79 (2025) and substantially similar to provisions in HCS/HB 1941, 2279, & 1681 (2026), SB 45 (2025), and similar to provisions in SB 187 (2025), SB 512 (2025), SB 1106 (2024), SB 844 (2024), SB 1190 (2024), HCS/HB 442 (2023), HB 1628 (2024), SB 269 (2023), and SB 1031 (2022). TAYLOR MIDDLETON

2026 Regular Session Introduced by Mike Bernskoetter

MDH must publish a public SURS MMIS procurement schedule by Oct 1, 2025 and provide a 60-day notice, boosting transparency and vendor prep for fraud-detection upgrades.

Second Read and Referred S Insurance and Banking Committee
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Bill Summary · SB 840

Summary — SB 840: Medicaid MMIS — SURS Procurement Schedule

Status and scope
- Short title: Requires the Maryland Department of Health (MDH) to publish a public schedule for procuring a Surveillance and Utilization Review Subsystem (SURS) of the Medicaid Management Information System (MMIS).
- Jurisdiction: Maryland (Senate Bill 840, Finance Committee).
- Effective date in bill text: takes effect July 1, 2025.
- Key deadlines imposed by the bill:
- On or before October 1, 2025: MDH must publish on its website a schedule for issuance of the solicitation for the SURS procurement.
- At least 60 days before issuance of the solicitation: MDH must publish written notice on its website describing contracting procedures, requirements, and timetables.

Purpose and intent
- Increase transparency and predictability of the procurement process for the SURS component of MMIS by providing prospective vendors and stakeholders with an advance schedule and clear notice of contracting requirements.
- Support MDH’s planned modernization of SURS as part of a broader MMIS replacement to improve automation, compliance monitoring, and fraud/waste/abuse detection.

Key provisions
- Publication requirement: MDH must post (1) a schedule for issuing the SURS solicitation by Oct 1, 2025 and (2) a written notice detailing contracting procedures, requirements, and timelines at least 60 days before solicitation.
- Location for posting: MDH’s website (and, per agency practice, the eMaryland Marketplace procurement portal).
- No new funding authorization or grant program; the bill does not create new procurement authority beyond existing MDH responsibilities.

Who is affected
- Maryland Department of Health: responsible for preparing and posting the schedule and procurement notices and conducting the subsequent solicitation.
- Potential vendors/contractors: gain earlier notice and clearer procedural information to prepare proposals for the SURS solicitation.
- Medicaid program integrity staff and MMIS modernization teams: procurement transparency may facilitate a smoother acquisition and transition to a modern SURS.
- Medicaid providers and beneficiaries: indirectly affected by potential improvements in fraud detection, claims review, and program integrity once a new SURS is procured and implemented.

Fiscal and operational impact
- Fiscal Note (MD Legislative Services): Minimal — MDH can publish the required information using existing budgeted resources; no revenue impact.
- Operational: Aligns with MDH plans to modernize SURS as part of MMIS replacement; the agency indicated a solicitation was expected within 60–90 days (around the bill’s introduction), and will post notices on its public procurement pages.

Implementation considerations
- MDH must coordinate publication timing to meet the 60‑day notice requirement ahead of solicitation issuance.
- The bill does not specify solicitation content, award criteria, or implementation timelines beyond the posting requirements; those will be established in the subsequent procurement documents and contract.

Compiled from official sources — confirm details with the bill’s official record.

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