New Maryland laws coming into effect New Year's Day 2026

Racquel Bazos, The Baltimore Sun on Dec 21, 2025

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BALTIMORE — As the state prepares for its annual General Assembly session beginning Jan. 14, 2026, there are still new laws from last session set to take effect on New Year’s Day.

Below is a sample of some of the changes coming to Maryland law on Jan. 1, 2026.

No time limits on anesthesia coverage

House Bill 1086 states that if medical insurers in the state, including the Maryland Medical Assistance Program, cover anesthesia for a procedure, they have to cover it for the duration of the procedure and also cover care related to the anesthesia’s delivery immediately before and after the procedure. Insurance carriers and Medicaid cannot 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 to not cover anesthesia over 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 stage four advanced metastatic cancers. Fail-first protocols require patients to use one or a sequence of, usually cheaper, prescription drugs before their insurance company covers medication prescribed to them by their providers.

For diabetics, the new statutes prohibit step therapies for FDA-approved insulin and insulin analogs. For advanced cancer patients, the new laws expand coverage to symptoms and side effects, as the existing law already prohibited step therapy for the treatment of advanced stage four cancer itself. The use of the prescribed drug must be considered a best practice and supported by medical literature, and it must be 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 authorizations for a transfer to “special pediatric hospitals.” The law defines special pediatric hospitals as in-state facilities that provide non-acute medical, rehabilitation, therapy or palliative services to patients under 22 or those between ages 2 and 23 if they have 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 provide their firefighters coverage for preventive cancer screenings without co-pays, co-insurance or deductibles.

Counties can either provide a no-cost annual exam for their firefighters per 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 about the cancer screenings provided in 2026 and 2027 to report to the Maryland Health Care Commission.

James “Jimmy” Malone was a former state delegate and career firefighter who died in 2024 of cancer. An American Cancer Society study from July found that firefighters are at 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.

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