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HB0970 amends Maryland’s insurance law to bar insurers, nonprofit health service plans, and health maintenance organizations from using step therapy or fail-first protocols for insulin and certain insulin analogs or similar medications used to treat diabetes. The bill specifically covers insulin used for type 1, type 2, and gestational diabetes, and it extends the prohibition to insulin analogs and other prescription drugs that perform a similar function, regardless of how they are formulated or administered.
The bill leaves in place the existing prohibition on step therapy for certain stage four advanced metastatic cancer drugs, but adds diabetes-related coverage protections to the same section of law. It applies to health insurance policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2026. In practical terms, the measure limits insurers’ ability to require patients to try lower-cost or preferred medications before covering prescribed insulin-related treatments.
The bill amends Section 15-142 of the Maryland Insurance Article, expanding the state’s existing step-therapy restrictions to include insulin and related diabetes medications. It affects insurers, nonprofit health service plans, and health maintenance organizations that provide hospital, medical, surgical, or prescription drug coverage in Maryland, including coverage administered through pharmacy benefits managers. The law does not eliminate utilization management generally, but it removes step therapy/fail-first requirements for the specified diabetes drugs beginning with plans renewed or issued on or after January 1, 2026.
The available record shows no committee transcript or vote breakdown, so there is no documented floor debate or recorded opposition in the materials provided. Based on the bill’s subject matter and the nature of the amendment, the measure appears to be a patient-protection bill aimed at improving access to essential diabetes medications. The absence of recorded votes or discussion snippets limits the ability to assess the full range of legislative sentiment, but the enacted law suggests it received sufficient support to pass and be signed by the Governor.
The main policy issue implicated by the bill is the balance between patient access and insurer utilization controls. Supporters would likely favor the bill for preventing delays or barriers to insulin access, especially for patients whose prescribed therapy should not be subject to step-therapy substitutions. Potential concerns from insurers or pharmacy benefit managers would center on reduced flexibility in managing drug costs and formulary controls, particularly because the bill covers not only insulin but also insulin analogs and other similar-function drugs. No specific named opponents or disputed amendments are reflected in the provided materials.