# Maryland HB 1243: Health Insurance - Coverage for Specialty Drugs Maryland HB 1243, Health Insurance - Coverage for Specialty Drugs, is a 2025 Regular Session House bill sponsored by Steve Johnson (Democratic); status signed, last action 2025-05-20 (Approved by the Governor - Chapter 729); PRIA reads it as touching household money (as of 2026-10-17). - Canonical: https://policyrisk.com/state-bill/MD-HB1243-2025RS - As of: 2026-10-17 - Plain-text twin of the page above; the HTML and this file carry the same facts. ## Facts - Bill: Maryland HB 1243 - State: Maryland - Session: 2025 Regular Session - Title: Health Insurance - Coverage for Specialty Drugs - Status: signed - Chamber: House - Introduced: 2025-02-07 - Last action: 2025-05-20, Approved by the Governor - Chapter 729 - Sponsor: Steve Johnson (Democratic) - Cosponsors: 23 - Subjects: Health - Insurance, Drugs -see also- Cannabis; ControlDangSubst; Pharm; etc., Health Insurance -see also- ACA; HMOs; MCOs, Health Maintenance Organizations -see also- Manage Care Orgs, Health Occupations -see also- (specific health occupations), Health Services Cost Review Commission, Medical Treatments, Nonprofit Organizations, Prices -see also- Consumer Price Index, Reimbursement Rates, Rules and Regulations - Touches household money: yes - Roll calls: 2 (183 yes, 2 no in all) - Economic provisions PRIA read: 3 ## Summary No summary available. ## Bill overview: provisions PRIA read - More specialty-drug coverage for Maryland patients: benefit, high. For Maryland policies issued, delivered, or renewed beginning January 1, 2026, private health plans cannot exclude qualifying specialty-drug coverage. The provider must be legally authorized, in-network for covered oncology services, and follow state specialty-drug rules. Covered types include infu… - Fairer specialty-drug payments for pharmacies: benefit, low. Beginning January 1, 2026, pharmacy benefit managers working for insurers face payment-parity rules for covered specialty drugs. They cannot pay a pharmacy or pharmacist less than themselves or an affiliated business for the same product or service. The law includes a specialty-drug exception and c… - Payment rules for specialty-drug providers: benefit, low. Beginning January 1, 2026, health plans and covered in-network providers must agree on payment for specialty drugs covered by this law. Providers must bill these drugs at a nonhospital level of care or place of service. Payment cannot exceed the designated specialty pharmacy's rate unless the plan… ## Sponsors and cosponsors - Sponsor: Steve Johnson (Democratic), House - Cosponsor: Tiffany T. Alston (Democratic), House - Cosponsor: Heather Bagnall (Democratic), House - Cosponsor: Harry Bhandari (Democratic), House - Cosponsor: Brian Chisholm (Republican), House - Cosponsor: Bonnie Cullison (Democratic), House - Cosponsor: Pam Lanman Guzzone (Democratic), House - Cosponsor: Terri L. Hill (Democratic), House - Cosponsor: Thomas S. Hutchinson (Republican), House - Cosponsor: Anne R. Kaiser (Democratic), House - Cosponsor: Kenneth Kerr (Democratic), House - Cosponsor: Nicholaus R. Kipke (Republican), House - Cosponsor: Lesley J. Lopez (Democratic), House - Cosponsor: Matthew Morgan (Republican), House - Cosponsor: Ashanti Martinez (Democratic), House - Cosponsor: Joseline A. Peña-Melnyk (Democratic), House - Cosponsor: Teresa E. Reilly (Republican), House - Cosponsor: Samuel I. Rosenberg (Democratic), House - Cosponsor: Kim Ross (Democratic), House - Cosponsor: Kathy Szeliga (Republican), House - Cosponsor: Deni Taveras (Democratic), House - Cosponsor: Jennifer White Holland (Democratic), House - Cosponsor: Jamila J. Woods (Democratic), House - Cosponsor: Teresa Woorman (Democratic), House ## Roll call votes | Date | Chamber | Motion | Result | Yes | No | Other | | --- | --- | --- | --- | --- | --- | --- | | 2025-04-02 | Senate | Third Reading Passed | pass | 46 | 0 | 1 | | 2025-03-13 | House | Third Reading Passed | pass | 137 | 2 | 1 | ## Actions (15) - 2025-05-20: Approved by the Governor - Chapter 729 - 2025-04-02: Returned Passed (House) - 2025-04-02: Third Reading Passed (46-0) (Senate) - 2025-03-28: Second Reading Passed (Senate) - 2025-03-28: Favorable Adopted (Senate) - 2025-03-27: Favorable Report by Finance (Senate) - 2025-03-17: Referred Finance (Senate) - 2025-03-13: Third Reading Passed (137-2) (House) - 2025-03-12: Second Reading Passed with Amendments (House) - 2025-03-12: Favorable with Amendments {733628/1 Adopted (House) - 2025-03-12: Favorable with Amendments Report by Health and Government Operations (House) - 2025-02-26: Hearing 2/27 at 2:00 p.m. (House) - 2025-02-26: Hearing canceled (House) - 2025-02-12: Hearing 2/27 at 1:00 p.m. (House) - 2025-02-07: First Reading Health and Government Operations (House) ## Bill text - Enacted, 2025-05-20: [PDF](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_729_hb1243t.pdf) - Third Reading, 2025-03-12: [PDF](https://mgaleg.maryland.gov/2025RS/bills/hb/hb1243t.pdf) - First Reading, 2025-02-07: [PDF](https://mgaleg.maryland.gov/2025RS/bills/hb/hb1243f.pdf) ## Related bills - SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions (vetoed) - SB 0157: Maryland Disability Service Animal Program - Established (vetoed) - HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination Review Process (vetoed) - HB 0384: Maryland Disability Service Animal Program - Established (vetoed) - HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization (became law) - HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard (signed) ## Sources - [Enacted (PDF)](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_729_hb1243t.pdf) - [Third Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/hb/hb1243t.pdf) - [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/hb/hb1243f.pdf) ## Related - [SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions](https://policyrisk.com/state-bill/MD-SB0227-2025RS) - [SB 0157: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-SB0157-2025RS) - [HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination…](https://policyrisk.com/state-bill/MD-HB0482-2025RS) - [HB 0384: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-HB0384-2025RS) - [HB 1294: Commercial Law - Credit Regulation - Earned Wage Access and Credit Modernization](https://policyrisk.com/state-bill/MD-HB1294-2025RS) - [HB 0228: Maryland Veterans Trust – Assistance to Members of the Maryland National Guard](https://policyrisk.com/state-bill/MD-HB0228-2025RS) - [Maryland bills](https://policyrisk.com/states/maryland/bills) - [Maryland state hub](https://policyrisk.com/states/maryland) - [All state legislation](https://policyrisk.com/state-bills) Source: PRIA, https://policyrisk.com/state-bill/MD-HB1243-2025RS (as of 2026-10-17).