Senate Bill 306: A Direct Threat to Maryland’s Injured Workers and Independent Pharmacies

If Senate Bill 306 passes, it will severely harm injured workers in Maryland. At the same time, it will enrich large insurance companies and Pharmacy Benefit Managers (PBMs) at the expense of patients and small, local pharmacies.

What SB306 Will Actually Do

This bill would:

1. Force independent pharmacies like RescueMeds out of business.

2. Block injured workers from getting their prescriptions in a timely and accessible way.

3. Redirect patients to PBM-owned pharmacies like Optum and Express Scripts, which profit from so-called “legal kickbacks” through rebates.

Importantly, the reimbursement rates outlined in the bill do not apply to PBMs, giving them a major — and unfair — advantage.

What Is SB306?

Senate Bill 306 was introduced by the Chair of the Senate Finance Committee.
The bill proposes to create a Fee Guide for prescription reimbursement under Maryland’s Workers’ Compensation system.

• Hearing Date: Wednesday, March 26 at 1:00 PM

• Location: Annapolis, Maryland

Why This Matters

At first glance, the idea of a Fee Guide might seem reasonable. In fact, we support having a fair and structured Fee Guide. Currently, Maryland uses a vague “Usual and Customary” reimbursement model.

However, when you look closer, problems arise.

Across the country, 35 states have already adopted a Fee Guide — and the majority use Average Wholesale Price (AWP). This model works because:

• It reflects market-based pricing

• It accommodates the complex nature of workers’ comp cases

• It accounts for denials, delays, and administrative risk

Therefore, we use AWP to ensure consistency and fairness — for both providers and patients.

Who Really Wins If SB306 Passes?

Let’s be clear: Chesapeake Employers Insurance Company (CEIC) has been working to eliminate pharmacies like RescueMeds since 2018. At that time, they attempted (and failed) to force injured workers to use only their selected pharmacies.

Now, with SB306, they are trying again — only more quietly.

This time, the bill would:

• Force care through PBM-owned pharmacies

• Deny prescriptions through bureaucratic tactics

• Use rebate structures that benefit insurance companies, not patients

These rebates are legal, but they function like kickbacks, benefiting PBMs and insurers through hidden financial arrangements. Meanwhile, independent pharmacies are left out of the loop and underpaid.

Why “Acquisition Cost” Is a Problem

SB306 proposes that pharmacies be reimbursed based on NADAC (National Average Drug Acquisition Cost) — which is essentially the price we pay to purchase medications.

On the surface, this might sound fair. But in reality, it’s not. Here’s why:

• No other state uses NADAC as a reimbursement standard for workers’ comp.

• There’s no margin for operational costs, staffing, compliance, or service.

• If we lose money on every prescription, we simply can’t afford to dispense.

Ultimately, this would cause many pharmacies to stop serving injured workers altogether — leaving patients without access to care.

Unfair Practices and Conflicts of Interest

Moreover, there are serious ethical concerns surrounding SB306:

• It was introduced by a Senator whose daughter is financially connected to a PBM.

• The bill excludes PBMs from the reimbursement rules, allowing them to operate by different standards.

• It discriminates against independent pharmacies, favoring big corporations.

In short, this is not just unfair — it’s unethical.

How SB306 Hurts Injured Workers

If passed, this bill will have serious consequences. It will:

• Delay access to prescriptions through stricter preauthorization requirements

• Increase pharmacy deserts, especially in rural or underserved areas

• Force patients to use pharmacies that are financially tied to insurers

• Deny legitimate prescriptions for cost-cutting reasons

• Erode trust in Maryland’s workers’ compensation system

These outcomes mean more delays, more suffering, and a longer path to recovery for tens of thousands of injured workers.

Here’s What Maryland Should Do Instead

Rather than push through SB306, Maryland should:

• Follow the 35 other states that use AWP-based reimbursement

• Protect patient choice by supporting independent pharmacies

• Increase transparency and fairness in PBM rebate practices

• Hold insurance companies accountable for delays and denials

• Ensure ethical lawmaking by eliminating conflicts of interest

We believe in doing the right thing. Injured workers deserve fast, fair, and reliable access to their medications — not delays, denials, and corporate greed.

Bottom Line: Oppose SB306

SB306 is dangerous for Maryland’s injured workers. It:

• Favors PBMs and insurers

• Punishes independent pharmacies

• Reduces access to essential medications

• Raises serious ethical concerns

Join us in opposing Senate Bill 306 by signing the Petition to STOP SB306.