Bill > HB1013

This bill aims to improve access to nonopioid pain medications for patients in Maryland by requiring the Maryland Medical Assistance Program and health insurers to treat nonopioid pain drugs with the same level of coverage and fewer restrictions as opioid pain medications. Specifically, beginning July 1, 2026, the bill prohibits health insurance providers from applying more restrictive prior authorization requirements, step therapy protocols, or fail-first protocols for nonopioid pain drugs compared to those applied to opioid pain medications. The bill defines step therapy (or fail-first protocol) as a requirement that patients try a specific sequence of prescription drugs before an insurer will cover a prescribed medication. Additionally, insurers must submit a plan to the Maryland Insurance Administration by December 1, 2026, detailing how they will provide comprehensive pain management services, including nonopioid drugs and alternative pain management methods. The Maryland Insurance Administration will review these plans to ensure compliance and prevent preferential treatment of opioid drugs. The provisions will apply to all health insurance policies issued or renewed in the state on or after January 1, 2026, with the goal of providing patients with more flexible and potentially safer pain management options.

Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB1013?ys=2025RS