Bill > HB970

This bill prohibits health insurance providers, nonprofit health service plans, and health maintenance organizations from implementing step therapy or "fail-first" protocols for insulin or insulin analogs used to treat Type 1, Type 2, or gestational diabetes. Step therapy is a protocol that requires patients to try less expensive or alternative prescription drugs before the insurance will cover the originally prescribed medication. The bill defines step therapy as a protocol that mandates a specific sequence of prescription drugs be used before covering a prescriber's preferred medication. The legislation applies to insurers and health maintenance organizations providing hospital, medical, or surgical benefits through policies or contracts issued or delivered in Maryland. The bill will take effect on January 1, 2026, and will apply to all health insurance policies, contracts, and benefit plans issued, delivered, or renewed in the state on or after that date. By preventing insurers from requiring patients to try alternative insulin treatments before covering their prescribed medication, the bill aims to ensure more direct and potentially more effective diabetes treatment for patients.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0970?ys=2025RS