Bill > SB646

This bill prohibits health insurers, nonprofit health service plans, and health maintenance organizations from using step therapy or fail-first protocols for insulin or insulin analogs used to treat diabetes. Step therapy is a protocol that requires patients to try less expensive or alternative medications before the insurer will cover the prescribed medication, which can delay effective treatment. The bill specifically prevents these healthcare entities from mandating that patients try other medications before covering insulin for patients with Type 1, Type 2, or gestational diabetes. Currently, such protocols can create barriers to accessing appropriate diabetes medication. The legislation will apply to all health insurance policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2026. By preventing insurers from requiring patients to try less effective or cheaper medications first, the bill aims to ensure that individuals with diabetes can more quickly access the specific insulin treatment recommended by their healthcare provider, potentially improving patient outcomes and reducing treatment delays.

Budget and Finance, Government Affairs, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0646?ys=2025RS