Md. Code, Ins. § 15-142. Step therapy or fail-first protocols: Health Insurance, General Provisions – Maryland

Status: Enacted
Year Enacted: 2014
Year Amended: 2017
File: Download

An entity subject to this section may not impose a step therapy or fail-first protocol on an insured or an enrollee if the step therapy drug has not been approved by the U.S. Food and Drug Administration for the medical condition being treated; or a prescriber provides supporting medical information to the entity that a prescription drug covered by the entity was ordered by a prescriber for the insured or enrollee within the past 180 days; and based on the professional judgment of the prescriber, was effective in treating the insured’s or enrollee’s disease or medical condition.


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