Bill > HB1087

This bill prohibits health insurers, nonprofit health service plans, and health maintenance organizations from requiring step therapy (a protocol that mandates trying less expensive or alternative medications before covering a prescribed drug) for certain prescription drugs used by patients with stage four advanced metastatic cancer. Specifically, the bill prevents these entities from imposing step therapy when the prescription drug is either directly treating the patient's stage four cancer and is consistent with FDA-approved indications and supported by peer-reviewed medical literature, or when the drug is prescribed by a treating physician to manage symptoms or side effects related to the cancer treatment. The drug must be consistent with best practices for treating stage four metastatic cancer, its associated conditions, or treatment side effects, and must be covered under the patient's insurance policy. The law will apply to all health insurance policies, contracts, and benefit plans issued or renewed on or after January 1, 2026, effectively giving healthcare providers and insurers time to adapt to the new requirements and providing additional support for patients dealing with advanced metastatic cancer.

Budget and Finance, Health and Social Services

https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB1087?ys=2025RS