MD SB921

Prohibits insurers, nonprofit health service plans, and health maintenance organizations from imposing step therapy or fail-first protocols on FDA-approved prescription drugs used to treat stage four advanced metastatic cancer

Expands existing protections to include drugs prescribed by a treating physician to treat symptoms of or side effects from stage four advanced metastatic cancer treatment

Requires that covered drugs be consistent with FDA-approved indications, National Comprehensive Cancer Network guidelines, or best practices for treating metastatic cancer and its associated conditions, and be supported by peer-reviewed medical literature

Applies to all health insurance policies, contracts, and health benefit plans issued, delivered, or renewed in Maryland on or after January 1, 2026

Signed into law by Governor Wes Moore on May 20, 2025