For years, thousands of Marylanders facing serious health battles have dealt with a frustrating “middleman” between them and their medication: their insurance company. Under a practice known as Step Therapy—or more bluntly, “Fail-First”—insurers could legally require patients to try (and fail on) cheaper, alternative medications before agreeing to cover the specific drug their doctor originally prescribed.
Doctor Knows Best: Maryland’s New Law Ends the Insurance “Fail-First” Gamble
That is about to change. Starting January 1, 2026, a landmark Maryland law officially bans “Fail-First” protocols for some of the State most vulnerable patients, shifting the final medical decision back where it belongs—between the doctor and the patient.
What is the “Fail-First” Ban?
The new legislation targets the practice of forcing patients to “step through” a sequence of lower-cost drugs. In many cases, these initial drugs were less effective or caused side effects that the doctor was trying to avoid…