Public Health - Recommendations for Immunizations, Screenings, and Preventive Services - Pharmacist Administration and Required Health Insurance Coverage (The Vax Act)

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0637*

HOUSE BILL 637
J3, J5, J2 6lr0344
CF SB 385
By: The Speaker (By Request – Administration) and Delegates Acevero, Allen,
Amprey, Behler, Bhandari, Boafo, Boyce, Coley, Ebersole, Edelson, Fennell,
Foley, Forbes, Guyton, Harrison, Hill, Holmes, Ivey, D. Jones, Kaufman,
Lewis, Mireku –North, Moon, Moreno, Odom, Palakovich Carr, Pasteur,
Patterson, Phillips, Pruski, Qi, Roberts, Rogers, Ross, Ruff, Simmons,
Solomon, Spiegel, Stewart, Taveras, Turner, Vogel, Watson, White Holland,
Wims, Woods, Wu, and Ziegler Ziegler, Bagnall, Cullison, Guzzone, Lopez,
Martinez, Rosenberg, and Woorman
Introduced and read first time: January 30, 2026
Assigned to: Health
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 8, 2026

CHAPTER ______

AN ACT concerning 1

Public Health – Recommendations for Immunizations, Screenings, and 2
Preventive Services – Pharmacist Administration and Required Health 3
Insurance Coverage 4
(The Vax Act) 5

FOR the purpose of requiring the Secretary of Health to issue recommendations for certain 6
immunizations, screenings, and preventive services based on certain evidence–based 7
scientific and clinical guidance; requiring the Secretary, before adopting a 8
recommendation for a cert ain preventive service, to hold a notice and comment 9
period, obtain a certain analysis from the Maryland Health Care Commission, and 10
cite the basis for the recommendation; altering the authority of pharmacists to 11
administer certain vaccinations; altering t he health insurance coverage 12
requirements for certain immunizations, screenings, and preventive services; 13
repealing obsolete language regarding the pertussis vaccine; and generally relating 14
to immunizations, screenings, and preventive services. 15

BY repealing 16
Article – Health – General 17
2 HOUSE BILL 637

Section 18–328 through 18–332 and the part “Part V. Pertussis” 1
Annotated Code of Maryland 2
(2023 Replacement Volume and 2025 Supplement) 3

BY adding to 4
Article – Health – General 5
Section 18–112 6
Annotated Code of Maryland 7
(2023 Replacement Volume and 2025 Supplement) 8

BY repealing and reenacting, with amendments, 9
Article – Health Occupations 10
Section 12–508 11
Annotated Code of Maryland 12
(2021 Replacement Volume and 2025 Supplement) 13

BY repealing and reenacting, with amendments, 14
Article – Insurance 15
Section 15–1A–10 and 15–817 16
Annotated Code of Maryland 17
(2017 Replacement Volume and 2025 Supplement) 18

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 19
That Section(s) 18–328 through 18–332 and the part “Part V. Pertussis” of Article – Health 20
– General of the Annotated Code of Maryland be repealed. 21

SECTION 2. AND BE IT FURTHER ENACTED, That the Laws of Maryland read 22
as follows: 23

Article – Health – General 24

18–112. 25

(A) THE SECRETARY SHALL ISSUE RECOMMENDATIONS FOR 26
IMMUNIZATIONS, SCREENINGS, AND PREVENTIVE SERVI CES FOR INFANTS , 27
CHILDREN, AND ADULTS THAT FOLL OW THE GENERALLY ACC EPTED CONSENSUS 28
WITHIN THE SCIENTIFI C COMMUNITY AND SOUN D CLINICAL GUIDANCE AS 29
SPECIFIED IN SUBSECTION (B) OF THIS SECTION AND SUBJECT TO SUBSECTION (C) 30
OF THIS SECTION. 31

(B) THE RECOMMENDATIONS SHALL: 32

(1) BE MADE IN ACCORDANCE WITH THE APPLICABLE 33
RECOMMENDATIONS OF T HE FOLLOWING AUTHORI TATIVE MEDICAL 34
ORGANIZATIONS: 35

HOUSE BILL 637 3

(I) THE AMERICAN ACADEMY OF PEDIATRICS; 1

(II) THE AMERICAN COLLEGE OF OBSTETRICIANS AND 2
GYNECOLOGISTS; OR 3

(III) THE AMERICAN ACADEMY OF FAMILY PHYSICIANS; AND 4

(2) TAKE INTO CONSIDERATION THE APPLICABLE GUIDANCE OF: 5

(I) THE MARYLAND STATEWIDE ADVISORY COMMISSION ON 6
IMMUNIZATIONS; 7

(II) THE U.S. DEPARTMENT OF HEALTH AND HUMAN 8
SERVICES, INCLUDING THE HEALTH RESOURCES AND SERVICES ADMINISTRATION; 9

(III) THE U.S. CENTERS FOR DISEASE CONTROL AND 10
PREVENTION, INCLUDING THE ADVISORY COMMITTEE ON IMMUNIZATION 11
PRACTICES; 12

(IV) THE U.S. FOOD AND DRUG ADMINISTRATION, INCLUDING 13
THE VACCINES AND RELATED BIOLOGICAL PRODUCTS ADVISORY COMMITTEE; 14
AND 15

(V) THE U.S. PREVENTIVE SERVICES TASK FORCE. 16

(C) BEFORE ADOPTING A REC OMMENDATION FOR A PREVENTIVE SERVICE 17
THAT IS NOT AN IMMUNIZATION AND HAS NOT RECEIVED A RECOMMENDATION FROM 18
THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OR AN A OR B RATING 19
FROM THE U.S. PREVENTIVE SERVICES TASK FORCE, THE SECRETARY SHALL: 20

(1) HOLD A NOTICE AND COMMENT PERIOD OF AT LEAST 30 DAYS; 21

(2) OBTAIN AN ANALYSIS FR OM THE MARYLAND HEALTH CARE 22
COMMISSION ON THE SERVICE THAT MEETS THE REQUIREMENTS OF § 15–1501 OF 23
THE INSURANCE ARTICLE; AND 24

(3) CITE THE APPLI CABLE RECOMMENDATIONS OF T HE 25
AUTHORITATIVE MEDICAL ORGANIZATIONS ON WHICH A RECOMMENDATION WOULD 26
BE BASED. 27

(C) (D) THE SECRETARY SHALL: 28

(1) PUBLISH RECOMMENDATIONS ISSUED UNDER THIS SECTION ON 29
THE DEPARTMENT’S WEBSITE; AND 30
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(2) DISTRIBUTE THE RECOMMENDATIONS ISSU ED UNDER THIS 1
SECTION TO LICENSED HEALTH PROFESSIONALS IN THE STATE AND TO THE 2
MARYLAND INSURANCE ADMINISTRATION. 3

Article – Health Occupations 4

12–508. 5

(a) (1) Subject to paragraph (4) of this subsection, a pharmacist may order and 6
administer a vaccination to an individual who is at least 3 years old if: 7

(i) The vaccine is: 8

1. An influenza vaccine; 9

2. A COVID–19 vaccine; or 10

3. Used in response to a public health emergency; 11

(ii) The pharmacist has completed a practical training program of at 12
least 20 hours that is approved by the Accreditation Council for Pharmacy Education and 13
includes: 14

1. Hands–on injection techniques; 15

2. Clinical evaluation of indications and contraindications of 16
vaccines; and 17

3. The recognition and treatment of emergency reactions to 18
vaccines; 19

(iii) The pharmacist has a current certificate in basic 20
cardiopulmonary resuscitation; 21

(iv) The pharmacist has completed a minimum of 2 hours of 22
continuing pharmaceutical educati on related to immunizations that is approved by the 23
Accreditation Council for Pharmacy Education as part of the license renewal requirements 24
under § 12–309 of this title; 25

(v) The pharmacist complies with the record–keeping and reporting 26
requirements in paragraph (5) of this subsection and any corresponding regulations 27
adopted by the Board; and 28

(vi) If the vaccination is administered to an individual under the age 29
of 18 years, the pharmacist informs the child vaccination patient and adult caregiver who 30
HOUSE BILL 637 5

is accompanying the child of the importance of well –child visits with a pediatric primary 1
care provider and refers the patient to a pediatric primary care provider when appropriate. 2

(2) Subject to paragraph (4) of this subsection, a pharmacist who has met 3
the requirement of paragraph (1)(ii) through (vi) of this subsection may administer to an 4
individual who is at least 7 years old a vaccination that is: 5

(i) Recommended by the Centers for Disease Control and 6
Prevention’s Advisory Committee on Immunization Practices; [or] 7

(ii) Approved or authorized by the U.S. Food and Drug 8
Administration; OR 9

(III) RECOMMENDED BY THE SECRETARY OF HEALTH IN 10
ACCORDANCE WITH § 18–112 OF THE HEALTH – GENERAL ARTICLE. 11

(3) Subject to paragraph (4) of this subsection, a pharmacist who has met 12
the requirement of paragraph (1)(ii), (iii), and (iv) of this subsection may administer to an 13
adult a vaccination that is recommended in the Centers for Disease Control and 14
Prevention’s Health Information for International Travel. 15

(4) [(i)] A pharmacist shall administer a vaccination under paragraph 16
(1), (2), or (3) of this subsection under a written protocol that: 17

[1.] (I) Is vaccine specific; and 18

[2.] (II) Meets criteria established by the Department, in 19
consultation with the Board, the Board of Physicians, and the Board of Nursing, in 20
regulation. 21

[(ii) The recommendations of the Centers for Disease Control and 22
Prevention’s Advisory Committee on Immunization Practices cited in this section refer to 23
federal statutes, rules, and guidance in effect: 24

1. On December 31, 2024; or 25

2. At a later date to account for any new vaccines 26
recommended by the Centers for Disease Control and Prevention’s Advisory Committee on 27
Immunization Practices after December 31, 2024.] 28

(5) A pharmacist shall: 29

(i) Report all vaccinations administered by the pharm acist to the 30
ImmuNet Program established under § 18–109 of the Health – General Article; 31

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(ii) If the vaccination has been administered in accordance with a 1
prescription, document at least one effort to inform the individual’s authorized prescriber 2
that the vaccination has been administered; and 3

(iii) Except for an influenza vaccination administered under 4
paragraph (1) of this subsection, if the authorized prescriber is not the individual’s primary 5
care provider or if the vaccination has not been adm inistered in accordance with a 6
prescription, document at least one effort to inform the individual’s primary care provider 7
or other usual source of care that the vaccination has been administered. 8

(b) The Board shall: 9

(1) Set reasonable fees for the administration of vaccinations under this 10
section; and 11

(2) Adopt regulations that require a pharmacist to submit a registration 12
form to the Board that includes verification that the pharmacist: 13

(i) Has successfully completed a certification course approved by the 14
Board [that included instruction in the guidelines and recommendations of the Centers for 15
Disease Control and Prevention regarding vaccinations in effect on December 31, 2024 ]; 16
and 17

(ii) Is certified in basic cardiopulmonary resuscitation and obtained 18
the certification through in–person classroom instruction. 19

Article – Insurance 20

15–1A–10. 21

(a) Subject to subsection (e) of this section and except as provided in subsections 22
(b), (c), and (d) of this section, a carrier shall provide coverage for and may not impose any 23
cost–sharing requirements, including copayments, coinsurance, or deductibles for: 24

(1) evidence–based items or services that have in effect a rating of A or B 25
in the recommendations of the United States Preventive Ser vices Task Force with respect 26
to the individual involved; 27

(2) immunizations for routine use in children, adolescents, and adults that 28
have in effect a recommendation from the Advisory Committee on Immunization Practices 29
of the Centers for Disease Control and Prevention with respect to the individual involved, 30
if the recommendation: 31

(i) has been adopted by the Director of the Centers for Disease 32
Control and Prevention; or 33

HOUSE BILL 637 7

(ii) is listed on the Immunization Schedules of the Centers for 1
Disease Control and Prevention for routine use; 2

(3) with respect to infants, children, and adolescents, evidence –informed 3
preventive care and screenings provided for in comprehensive guidelines supported by the 4
Health Resources and Services Administration; and 5

(4) with respect to women: 6

(i) to the extent not provided in item (ii) of this item, preventive care 7
and screenings as provided for in comprehensive guidelines supported by the Health 8
Resources and Services Administration for purposes of § 2713(a)(4) of the federal Public 9
Health Service Act; and 10

(ii) subject to § 15 –826(c) of this title, contraceptive coverage as 11
provided for in comprehensive guidelines supported by the Health Resources and Services 12
Administration for purposes of § 2713(a)(4) of the federal Public Health Service Act. 13

(b) To the extent that cost –sharing is otherwise allowed under federal or State 14
law, a health benefit plan that uses a network of providers may impose cost –sharing 15
requirements on the coverage described in subsection (a) of this section for items or services 16
delivered by an out–of–network provider. 17

(c) (1) In this subsection, “high deductible health plan” has the meaning stated 18
in 26 U.S.C. § 223(c)(2). 19

(2) If an insured or enrollee is covered under a high deductible health plan, 20
a carrier may apply the deductible requirement of the high deductible health plan to the 21
coverage required under subsection (a) of this section, unless the Commissioner determines 22
that the coverage is included in the safe harbor pro visions for preventive care under 26 23
U.S.C. § 223(c)(2)(c). 24

(d) This section may not be construed to prohibit a carrier from providing 25
coverage for services in addition to those recommended by the United States Preventive 26
Services Task Force or to deny coverage for services that are not recommended by the Task 27
Force. 28

(e) Subject to § 15–826(c) of this title[: 29

(1)], the Commissioner shall enforce this section consistent with the 30
recommendations and guidelines in effect on December 31, 2024, set by th e United States 31
Preventive Services Task Force, the Advisory Committee on Immunization Practices of the 32
Centers for Disease Control and Prevention, or the Health Resources and Services 33
Administration, and related federal rules or guidance[; and 34

(2) the Commissioner may adopt regulations: 35

8 HOUSE BILL 637

(i) necessary to carry out this section, consistent with federal 1
statutes, rules, and guidance in effect: 2

1. on December 31, 2024; or 3

2. at a later date that enhance the scope of preventive 4
services to the benefit of consumers in the State; or 5

(ii) to require carriers to provide coverage without imposing 6
cost–sharing requirements, including copayments, coinsurance, or deductibles, for any 7
future preventive services recommendations and guidelines issued after December 31, 8
2024, by the United States Preventive Services Task Force, the Advisory Committee on 9
Immunization Practices of the Centers for Disease Control and Prevention, or the Health 10
Resources and Services Administration, and related federal rules or guidance], AS 11
UPDATED BY RECOMMENDATIONS ISSUED BY THE SECRETARY OF HEALTH IN 12
ACCORDANCE WITH § 18–112 OF THE HEALTH – GENERAL ARTICLE. 13

(F) A CARRIER SHALL PROVIDE THE COVERAGE DESCRIBED IN SUBSECTION 14
(A) OF THIS SECTION FOR PLAN YEARS THAT BEGIN ON OR AFTER THE DATE THAT IS 15
3 MONTHS 1 YEAR AFTER THE DATE THE R ECOMMENDATIONS DESCR IBED IN 16
SUBSECTION (E) OF THIS SECTION ARE ISSUED. 17

15–817. 18

(a) In this section, “child wellness services” means preventive activities designed 19
to protect children from morbidity and mortality and promote child development. 20

(b) This section applies to each individual hospital or major medical insurance 21
policy, group or blanket health insurance policy, and nonprofit health service plan that: 22

(1) is delivered or issued for delivery in the State; 23

(2) is written on an expense–incurred basis; and 24

(3) provides coverage for a family member of the insured. 25

(c) (1) A policy or plan subject to this section shall include under the family 26
member coverage a minimum package of child wellness services that are consistent with: 27

(i) public health policy; 28

(ii) professional standards; and 29

(iii) scientific evidence of effectiveness. 30

(2) The minimum package of child wellness services shall cover at least: 31
HOUSE BILL 637 9

(i) all visits for and costs of childhood and adolescent immunizations 1
recommended by the Advisory Committee on Immunization Practices of the Centers for 2
Disease Control and Prevention as of December 31, 2024 , AS UPDATED BY 3
RECOMMENDATIONS ISSUED BY THE SECRETARY OF HEALTH IN ACCORDANCE WITH 4
§ 18–112 OF THE HEALTH – GENERAL ARTICLE; 5

(ii) visits for the collection of adequate samples, the first of which is 6
to be collected before 2 weeks of age, for hereditary and metabolic newborn screening and 7
follow–up between birth and 4 weeks of age; 8

(iii) universal hearing screening of newborns provided by a hospital 9
before discharge; 10

(iv) all visits for and costs of age –appropriate screening tests for 11
tuberculosis, anemia, lead toxicity, hearing, and vision as dete rmined by the American 12
Academy of Pediatrics; 13

(v) all visits for obesity evaluation and management; 14

(vi) all visits for and costs of developmental screening as 15
recommended by the American Academy of Pediatrics; 16

(vii) a physical examination, dev elopmental assessment, and 17
parental anticipatory guidance services at each of the visits required under items (i), (ii), 18
(iv), (v), and (vi) of this paragraph; and 19

(viii) any laboratory tests considered necessary by the physician as 20
indicated by the services provided under items (i), (ii), (iv), (v), (vi), or (vii) of this paragraph. 21

(d) Except as provided in subsection (e) of this section, an insurer or nonprofit 22
health service plan that issues a policy or plan subject to this section, on notification of the 23
pregnancy of the insured and before the delivery date, shall: 24

(1) encourage and help the insured to choose and contact a primary care 25
provider for the expected newborn before delivery; and 26

(2) provide the insured with information on postpartum home visits for the 27
mother and the expected newborn, including the names of health care providers that are 28
available for postpartum home visits. 29

(e) An insurer or nonprofit health service plan that does not require or encourage 30
the insured to use a particular health care provider or group of health care providers that 31
has contracted with the insurer or nonprofit health service plan to provide services to the 32
insurer’s or nonprofit health service plan’s insureds need not comply with subsection (d) of 33
this section. 34

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(f) (1) A policy or plan subject to this section may not impose a deductible on 1
the coverage required under this section. 2

(2) Each health insurance policy and certificate shall contain a notice of the 3
prohibition established by paragraph (1) of this subsection in a form approved by the 4
Commissioner. 5

(g) The Commissioner may adopt regulations necessary to carry out subsection 6
(c)(2)(i) of this section consistent with federal statutes, rules, and guidance in effect[: 7

(1)] on December 31, 2024[; or 8

(2) at a later date to account for any new vaccines recommended by the 9
Centers for Disease Control and Prevention’s Advisory Committee on Immunization 10
Practices after December 31, 2024 ], AS UPDATED BY RECOMM ENDATIONS ISSUED BY 11
THE SECRETARY OF HEALTH IN ACCORDANCE WITH § 18–112 OF THE 12
HEALTH – GENERAL ARTICLE. 13

SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all 14
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 15
after January 1, 2027. 16

SECTION 4. AND BE IT FURTHER ENACTED, That this Act shall take effect July 17
1, 2026. 18

Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.