MD SB974

Prohibits Maryland Medicaid and private insurers from applying prior authorization, step therapy, or fail-first requirements for FDA-approved nonopioid pain medications that are more restrictive than those applied to opioid or narcotic pain drugs

Requires coverage of nonopioid pain treatment drugs to the same extent as covered opioid or narcotic pain medications, effective July 1, 2026 for Medicaid and January 1, 2026 for private insurance

Applies to insurers, nonprofit health service plans, health maintenance organizations, managed care organizations, and entities using pharmacy benefits managers

Mandates insurers submit plans to the Maryland Insurance Administration by December 1, 2026 demonstrating adequate coverage and access to broad pain management services, including nonopioid drugs and nonpharmacologic alternatives

Maryland Insurance Administration must review submitted plans for compliance and assess whether policies create unduly preferential coverage of opioid drugs