# Maryland SB 0921: Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer

Maryland SB 0921, Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer, is a 2025 Regular Session Senate bill sponsored by Dawn Gile (Democratic); status signed, last action 2025-05-20 (Approved by the Governor - Chapter 707); PRIA reads it as touching household money (as of 2026-10-17).

- Canonical: https://policyrisk.com/state-bill/MD-SB0921-2025RS
- As of: 2026-10-17
- Plain-text twin of the page above; the HTML and this file carry the same facts.

## Facts
- Bill: Maryland SB 0921
- State: Maryland
- Session: 2025 Regular Session
- Title: Health Insurance - Step Therapy or Fail-First Protocols - Drugs to Treat Associated Conditions of Advanced Metastatic Cancer
- Status: signed
- Chamber: Senate
- Introduced: 2025-02-03
- Last action: 2025-05-20, Approved by the Governor - Chapter 707
- Sponsor: Dawn Gile (Democratic)
- Cosponsors: 0
- Subjects: Health - Insurance, Health Maintenance Organizations, Drugs -see also- Cannabis; ControlDangSubst; Pharm; etc., Health -see also- COVID19; EnvHlth; MedCon; etc., Health Insurance -see also- ACA; HMOs; MCOs, Health Maintenance Organizations -see also- Manage Care Orgs, Health Occupations -see also- (specific health occupations), Medical Conditions -see also- AIDS; COVID-19; rabies, Medical Treatments, Nonprofit Organizations, Physicians -see also- MedExmnrs; Pediatr; Psychiatrists etc.
- Touches household money: yes
- Roll calls: 2 (183 yes, 1 no in all)
- Economic provisions PRIA read: 1

## Summary

No summary available.

## Bill overview: provisions PRIA read

- Fewer drug barriers for advanced cancer patients: benefit, medium. Beginning January 1, 2026, Maryland health insurers, nonprofit health plans, and HMOs cannot require patients to try other drugs before covering qualifying prescriptions. This applies to policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after that date, i…

## Sponsors and cosponsors

- Sponsor: Dawn Gile (Democratic), Senate

## Roll call votes

| Date | Chamber | Motion | Result | Yes | No | Other |
| --- | --- | --- | --- | --- | --- | --- |
| 2025-04-07 | House | Third Reading Passed | pass | 136 | 1 | 3 |
| 2025-03-31 | Senate | Third Reading Passed | pass | 47 | 0 |   |

## Actions (13)

- 2025-05-20: Approved by the Governor - Chapter 707
- 2025-04-07: Returned Passed (Senate)
- 2025-04-07: Third Reading Passed (136-1) (House)
- 2025-04-03: Favorable Adopted Second Reading Passed (House)
- 2025-04-03: Favorable Report by Health and Government Operations (House)
- 2025-04-02: Rereferred to Health and Government Operations (House)
- 2025-04-01: Referred Rules and Executive Nominations (House)
- 2025-03-31: Third Reading Passed (47-0) (Senate)
- 2025-03-28: Second Reading Passed with Amendments (Senate)
- 2025-03-28: Favorable with Amendments {613025/1 Adopted (Senate)
- 2025-03-27: Favorable with Amendments Report by Finance (Senate)
- 2025-02-06: Hearing 2/26 at 1:00 p.m. (Senate)
- 2025-02-03: First Reading Finance (Senate)

## Bill text

- First Reading, 2025-05-20: [PDF](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_707_sb0921t.pdf)
- First Reading, 2025-03-28: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0921t.pdf)
- First Reading, 2025-02-03: [PDF](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0921f.pdf)

## Related bills

- HB 0384: Maryland Disability Service Animal Program - Established (vetoed)
- SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions (vetoed)
- HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination Review Process (vetoed)
- SB 0157: 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
- [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/Chapters_noln/CH_707_sb0921t.pdf)
- [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0921t.pdf)
- [First Reading (PDF)](https://mgaleg.maryland.gov/2025RS/bills/sb/sb0921f.pdf)

## Related
- [HB 0384: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-HB0384-2025RS)
- [SB 0227: Workers' Compensation - Payment From Uninsured Employers' Fund - Revisions](https://policyrisk.com/state-bill/MD-SB0227-2025RS)
- [HB 0482: Occupational Licensing and Certification - Criminal History - Predetermination…](https://policyrisk.com/state-bill/MD-HB0482-2025RS)
- [SB 0157: Maryland Disability Service Animal Program - Established](https://policyrisk.com/state-bill/MD-SB0157-2025RS)
- [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-SB0921-2025RS (as of 2026-10-17).