New Maryland laws taking effect New Year's Day 2026

Racquel Bazos, The Baltimore Sun on Dec 20, 2025

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As the state prepares for its annual General Assembly session beginning Jan. 14, 2026, several laws passed last session are set to take effect Jan. 1.

Below is a sample of changes coming to Maryland law on New Year’s Day.

No time limits on anesthesia coverage

House Bill 1086 states that if medical insurers in Maryland, including the Maryland Medical Assistance Program, cover anesthesia for a procedure, they must cover it for the duration of the procedure and also cover care related to anesthesia delivery immediately before and after the procedure. Insurance carriers and Medicaid may not impose time limits on anesthesia delivery.

Late last year, the American Society of Anesthesiologists condemned a now-retracted proposal from Anthem Blue Cross Blue Shield not to cover anesthesia beyond a certain time limit.

Ending fail-first protocols for diabetes, metastatic cancer side effects

Starting Jan. 1, 2026, two sets of cross-filed bills prohibit medical insurance providers from requiring step therapy, also known as fail-first protocols, for Type 1, Type 2 or gestational diabetes, or for symptoms or side effects of advanced stage four metastatic cancers.

Fail-first protocols require patients to use one or a sequence of typically cheaper prescription drugs before their insurance company covers medication prescribed by their providers.

For patients with diabetes, the new statutes prohibit step therapy for FDA-approved insulin and insulin analogs. For advanced cancer patients, the new laws expand coverage to symptoms and side effects, as existing law already prohibited step therapy for treatment of advanced stage four cancer itself. The prescribed drug must be considered a best practice, supported by medical literature and covered under the patient’s plan.

No prior authorization for pediatric transfers

House Bill 1301 prohibits insurers, nonprofit health service plans, health maintenance organizations, Medicaid and the Maryland Children’s Health Program from requiring prior authorization for transfers to special pediatric hospitals. The law defines special pediatric hospitals as in-state facilities that provide nonacute medical, rehabilitation, therapy or palliative services to patients younger than 22, or those ages 2 to 23 with co-occurring physical and behavioral health conditions.

Cancer screenings for firefighters

The James “Jimmy” Malone Act, cross-filed as House Bill 459 and Senate Bill 374, requires counties that offer self-insured employee health plans to provide firefighters coverage for preventive cancer screenings without copays, coinsurance or deductibles.

Counties may either provide a no-cost annual exam for firefighters following the latest guidelines from the International Association of Firefighters or apply for a grant to pay for “innovative cancer screening technologies, including a multi-cancer early detection blood test,” the statute says. Under the law, counties must also collect data on cancer screenings provided in 2026 and 2027 and report that information to the Maryland Health Care Commission.

James “Jimmy” Malone was a former state delegate and career firefighter who died of cancer in 2024. A July American Cancer Society study found firefighters face an increased risk of mortality for skin, kidney and other cancers.

Domestic violence awareness for barbers, cosmetologists

Barbers and cosmetologists in Maryland must now complete domestic violence awareness training in order to become licensed. The training programs must be approved by the Department of Labor. Trainings must be at least an hour online or in-person and include guidance on how to recognize the signs of domestic violence, how to speak with clients who might be victims and connecting clients with resources and support groups for victims of domestic violence.

Barbers and cosmetologists in Maryland must complete domestic violence awareness training to become licensed, under the new law. Training programs must be approved by the Maryland Department of Labor and last at least one hour, either online or in person. The training must include guidance on recognizing signs of domestic violence, speaking with clients who may be victims and connecting them with resources and support groups.

Already licensed barbers and cosmetologists must complete the training during their next license renewal.

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