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EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1380*
HOUSE BILL 1380
J5 6lr2203
By: Delegate Fair
Introduced and read first time: February 13, 2026
Assigned to: Health
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Prescriptions for Gender–Affirming Care and Hormone 2
Therapy – Coverage and Dispensing Requirements 3
FOR the purpose of requiring insurers, nonprofit health service plans, and health 4
maintenance organizations to provide cove rage for a certain supply of prescription 5
drugs used for gender–affirming care or hormone therapy in certain circumstances; 6
altering the amount of certain prescription drugs that a pharmacist is allowed to 7
dispense on or after a certain date ; and generally relating to the coverage of 8
prescription drugs by health insurance carriers. 9
BY adding to 10
Article – Insurance 11
Section 15–864 12
Annotated Code of Maryland 13
(2017 Replacement Volume and 2025 Supplement) 14
BY repealing and reenacting, with amendments, 15
Article – Health Occupations 16
Section 12–512 17
Annotated Code of Maryland 18
(2021 Replacement Volume and 2025 Supplement) 19
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 20
That the Laws of Maryland read as follows: 21
Article – Insurance 22
15–864. 23
2 HOUSE BILL 1380
(A) (1) IN THIS SECTION , “QUALIFYING PRESCRIPTION” MEANS A 1
PRESCRIPTION FOR A PRESCRIPTION DRUG: 2
(I) USED TO MEDICALLY SU PPRESS, INCREASE, OR REPLACE 3
HORMONES THAT THE BODY IS NOT PRODUCING AT INTENDED LEVELS; OR 4
(II) RELATED TO GENDER–AFFIRMING TREATMENT, AS 5
DEFINED IN § 15–151 OF THE HEALTH – GENERAL ARTICLE, THAT IS LAWFUL IN THE 6
STATE. 7
(2) “QUALIFYING PRESCRIPTI ON” DOES NOT INCLUDE A 8
PRESCRIPTION FOR: 9
(I) A GLUCAGON –LIKE PEPTIDE –1 OR GLUCAGON –LIKE 10
PEPTIDE–1 RECEPTOR ANTAGONIST; 11
(II) A PRESCRIPTION DRUG THAT CANNOT BE SAFEL Y STORED 12
AT ROOM TEMPERATURE WITHOUT REFRIGERATION; OR 13
(III) A PRESCRIPTION PRESC RIBED FOR SINGLE USE, 14
EMERGENCY USE, OR FOR A NONRENEWABL E COURSE OF TREATMEN T THAT THE 15
PRESCRIBER DOES NOT INTEND TO CONTINUE ON AN ONGOING OR MAI NTENANCE 16
BASIS. 17
(B) THIS SECTION APPLIES TO: 18
(1) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 19
PROVIDE COVERAGE FOR QUALIFYING PRESCRIPTIONS UNDER HEALTH INSURANCE 20
POLICIES AND CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE; AND 21
(2) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 22
COVERAGE FOR PRESCRI PTIONS FOR QUALIFYING PRESCRIPT IONS UNDER 23
CONTRACTS THAT ARE ISSUED OR DELIVERED IN THE STATE. 24
(C) SUBJECT TO SUBSECTIONS (D) AND (E) OF THIS SECTION , AN ENTITY 25
SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR A SINGLE DISPENSING 26
TO AN INSURED OR ENR OLLEE OF A SUPPLY OF A QUALIFYING PRESCRIPTION FOR 27
UP TO A 12–MONTH PERIOD. 28
(D) FOR A QUALIFYING PRESCRIPT ION THAT IS FOR A CONTROLLED 29
SUBSTANCE, AN ENTITY SUBJECT TO THIS SECTION SHALL PROVIDE COVERAGE FOR 30
THE MAXIMUM SUPPLY THAT MAY BE DISPENSED AT ONE TIME UNDER FEDERAL AND 31
STATE LAW. 32
HOUSE BILL 1380 3
(E) AN ENTITY SUBJECT TO THIS SECTION MAY: 1
(1) TEMPORARILY LIMIT DISPENSING OF A QUALIFYING 2
PRESCRIPTION TO A 90–DAY SUPPLY IF THE QUALIFYING PRESCRIPTION IS FOR A 3
DRUG EXPERIENCING AN ACUTE DISPENSING SHORTAGE; 4
(2) LIMIT THE DISPENSING OF A QUALIFYING PRESCRIPT ION 5
OBTAINED DURING THE LAST QUARTER OF A PLAN YEAR IF A 12–MONTH SUPPLY OF 6
THE SAME QUALIFYING PRESCRIPTION WAS ALREADY DISPENSED DURING THE PLAN 7
YEAR; AND 8
(3) TO THE EXTENT AUTHORIZED UNDER FEDERAL AND STATE LAW, 9
APPLY UTILIZATION MANAGEMENT STRATEGIES TO A QUALIFYING PRESCRIPTION. 10
(F) AN ENTITY SUBJECT TO THIS SECTION MAY NOT REQUIRE AN ENROLLEE 11
TO ACCEPT A 12–MONTH SUPPLY OF A QUALIFYING PRESCRIPTION IF: 12
(1) THE ENROLLEE REQUEST S A SMALLER SUPPLY OF THE 13
QUALIFYING PRESCRIPTION; OR 14
(2) THE PRESCRIBING PROV IDER INDICATES THAT THE ENROLLEE 15
SHOULD RECEIVE A SMALLER SUPPLY OF THE QUALIFYING PRESCRIPTION. 16
Article – Health Occupations 17
12–512. 18
(a) (1) In this section [, “authorized prescriber” ] THE FOLLOWING WORDS 19
HAVE THE MEANINGS INDICATED. 20
(2) “AUTHORIZED PRESCRIBER” has the meaning stated in § 12 –101 of 21
this title. 22
(3) “QUALIFYING PRESCRIPTI ON” HAS THE MEANING STAT ED IN § 23
15–864 OF THE INSURANCE ARTICLE. 24
(b) This section does not apply to: 25
(1) A controlled dangerous substance as defined in § 5–101 of the Criminal 26
Law Article; or 27
(2) The first prescription or change in a prescription for a drug that an 28
authorized prescriber prescribes for a patient. 29
4 HOUSE BILL 1380
(c) Except as provided in subsection (d) of this section, a pharmacist may 1
dispense, in a single dispensing and exercising the professional judgment of the 2
pharmacist, a quantity of a prescription drug that: 3
(1) Is up to the total number of dosage units authorized by the prescr iber 4
on the original prescription and any refills of the prescription; 5
(2) Except for a contraceptive dispensed on or after January 1, 2020, OR A 6
QUALIFYING PRESCRIPTION DISPENSED AFTER JANUARY 1, 2027, does not exceed a 7
90–day supply of the prescription drug; [and] 8
(3) For a contraceptive dispensed on or after January 1, 2020, does not 9
exceed a 12–month supply of the prescription drug; AND 10
(4) FOR A QUALIFYING PRES CRIPTION DISPENSED A FTER JANUARY 11
1, 2027, DOES NOT EXCEED A 12–MONTH SUPPLY OF THE PRESCRIPTION DRUG. 12
(d) A pharmacist may not dispense, in a single dose, a quantity of a prescription 13
drug that exceeds the limit prescribed by a prescriber when the prescriber has indicated 14
that the prescription be dispensed only as prescribed. 15
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 16
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 17
after January 1, 2027. 18
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 19
January 1, 2027. 20