These Are The New Laws That Go Into Effect in Maryland in January

Maryland residents will see major changes to their health insurance, property taxes, and professional licenses when the new year arrives. More than a dozen new state laws take effect on January 1, 2026, affecting everything from how much insulin costs to what doctors can require before approving treatment.

What’s Happening: The Maryland legislature passed laws in 2024 and 2025 that reshape how insurance companies operate in the state. The changes focus on making it easier for patients to get the care they need and protecting workers in certain industries. Starting January 1, 2026, these laws become the rules that insurance companies must follow.

Insulin Will Be Easier To Get

Patients with diabetes will no longer have to try cheaper insulin first before their insurance covers the insulin their doctor prescribed. Two identical laws, one passed by the House and one by the Senate, prohibit insurance companies from using “step therapy” or “fail-first protocols” for insulin and insulin analogs used to treat Type 1, Type 2, or gestational diabetes. This means if a doctor prescribes a specific insulin, the insurance company cannot force a patient to try a different, cheaper insulin first.

Cancer Patients Get Faster Access To Drugs

People being treated for advanced metastatic cancer, also called stage four cancer, will no longer face delays in getting the drugs their doctors prescribe. Two laws prohibit insurance companies from requiring step therapy or fail-first protocols for prescription drugs that treat symptoms or side effects from stage four cancer treatment. The laws apply when a treating physician prescribes the drug and it is consistent with best practices for treating the condition.

Anesthesia Coverage Gets Clearer

Insurance companies will no longer be able to limit how long anesthesia can be used during a medical procedure. Starting January 1, 2026, the Maryland Medical Assistance Program, managed care organizations, and certain insurers must provide anesthesia coverage for the full duration of any procedure for which a licensed medical professional issues an order. Insurance companies cannot create policies that place time limits on anesthesia delivery.

Heart Disease Screening Becomes Covered

Insurance companies must now cover calcium score testing, a type of heart disease screening. The Maryland Medical Assistance Program and all insurers, nonprofit health service plans, health maintenance organizations, and managed care organizations must provide this coverage in accordance with the most recent guidelines from the American College of Cardiology. The requirement applies to all policies issued, delivered, or renewed on or after January 1, 2026.

Hearing Aids Will Be Easier To Get Covered

Adults who need hearing aids will have an easier time getting insurance coverage. Two identical laws change when insurance companies must cover hearing aids. Now, insurance companies must provide coverage for medically appropriate and necessary hearing aids for adults if the hearing aid is ordered, fitted, and dispensed by a licensed hearing aid dispenser.

Specialty Cancer Drugs Get New Protections

Insurance companies cannot refuse to cover specialty drugs used to treat cancer if those drugs are administered or dispensed by an in-network provider of covered oncology services. The provider must comply with state regulations for administering and dispensing specialty drugs and meet certain qualifications. The reimbursement rate for these specialty drugs must meet certain criteria set by law.

Insurance Companies Must Notify You Differently

When insurance companies cancel or choose not to renew a small group market health benefit plan, they must now provide notice through electronic means in addition to written notice. The notice must include information about other health benefit coverage options available to the group. This applies to all policies issued, delivered, or renewed on or after January 1, 2026.

How Insurance Calculates Your Costs Is Changing

Insurance companies must now count certain discounts, financial assistance payments, product vouchers, and other out-of-pocket expenses when calculating cost-sharing contributions for prescription drugs. This means if you receive help paying for a drug from a manufacturer or nonprofit organization, the insurance company must count that help toward your deductible or other cost-sharing amounts. Violating this rule is considered a violation of the Consumer Protection Act.

Specialists Outside Your Insurance Network Get Better Coverage

Insurance companies can no longer impose stricter requirements on patients who see specialists not in their insurance network. Two identical laws repeal a June 30, 2025, termination date for certain provisions related to referrals to and reimbursement of specialists and nonphysician specialists who are not part of a carrier’s provider panel. The laws prohibit carriers from imposing utilization review requirements other than what would be required if the covered benefit was provided by a provider on the carrier’s provider panel under certain circumstances.

Children Can Transfer To Special Hospitals Without Approval Delays

Insurance companies can no longer require prior authorization before a child transfers to a special pediatric hospital. The Maryland Medical Assistance Program, the Maryland Children’s Health Program, managed care organizations, and certain health insurers, nonprofit health service plans, and health maintenance organizations are prohibited from requiring prior authorization for these transfers.

Firefighters Get Cancer Screening Coverage

Counties that offer self-insured employee health benefit plans must provide firefighters employed by the county coverage for preventive cancer screenings in accordance with certain guidelines. Counties can satisfy this requirement by providing a no-cost annual examination or applying for a grant to pay for certain cancer screening technologies. Counties cannot impose a copayment, coinsurance, or deductible requirement on the coverage. The Maryland Health Care Commission must conduct a study and report by December 1, 2028.

Barbers And Cosmetologists Must Complete Domestic Violence Training

Beginning October 1, 2025, the State Board of Barbers and the State Board of Cosmetologists will require applicants and licensees to complete training in domestic violence awareness as a condition for licensure and initial renewal of a license. The Maryland Department of Labor must approve the training, which must be offered in person and virtually, include guidance on certain topics, and have a duration of at least one hour.

Property Tax Sales Get New Protections

Tax collectors can now withhold certain property from tax sale if it is occupied by an heir of a deceased owner. Each county must establish a registry for interested parties or the Tax Sale Ombudsman to designate property to be withheld from tax sale. The State Department of Assessments and Taxation will assist each county in creating and maintaining the registry.

Continuing Care Providers Must Add Alternate Board Members

Continuing care providers must now appoint an alternate subscriber member to their governing body. The alternate subscriber member can attend all meetings of the governing body and vote only if the regular subscriber is unable to fulfill the subscriber’s duties as a regular member.

Ride-Share Companies Must Report Driver Earnings

Transportation network companies must provide each operator with a weekly fare and earnings summary. These companies must also report certain information to the Public Service Commission on or before February 1 each year. The report submitted to the Commission may be made available to the General Assembly on request, provided that the report remains confidential and exempt from public disclosure.

Digital Advertising Tax Gets Appeal Process

Persons who are subject to the digital advertising gross revenues tax and receive a notice of assessment from the Comptroller can now appeal the assessment. The Comptroller or the Comptroller’s designee can issue an order to correct an erroneous assessment of the digital advertising gross revenues tax, subject to certain conditions. The law applies to assessments made after December 31, 2025.

Home Care Workers Must Be Classified As Employees

The Maryland Department of Health can only reimburse a residential service agency for personal assistance services if the personal assistance services are provided by an individual classified as an employee. This applies to reimbursement decisions made on or after January 1, 2026.