A package of new state laws will take effect on Jan. 1, 2026, bringing changes to tax-sale rules, rideshare driver reporting, and a wide slate of health insurance requirements — including new protections tied to pediatric care, anesthesia coverage, cancer screenings for firefighters, and limits on “fail-first” medication rules.
Below are some of the most notable changes, based on the Maryland General Assembly Department of Legislative Services “Effective Dates” list.
Housing and property tax
New protections in the tax-sale process (HB 59)
A new law revises Maryland’s tax-sale process by requiring counties to withhold certain owner-occupied properties — including certain homes occupied by heirs of deceased owners — from tax sale. It also requires each county to establish a registry so interested parties (or the Tax Sale Ombudsman) can designate eligible properties to be withheld, with assistance from the State Department of Assessments and Taxation.
Licensing and consumer protections
Domestic violence awareness training for barbers and cosmetologists (HB 1547)
Maryland will require domestic violence awareness training as a condition for licensure and an initial license renewal for barbers and cosmetologists. The law also directs the Maryland Department of Labor to approve training that can be taken in-person or virtually and lasts at least one hour.
Governance changes for continuing care providers (HB 938)
Continuing care providers must appoint an alternate subscriber member to their governing bodies. The alternate may attend meetings and vote only when the regular subscriber member cannot fulfill their duties.
Transportation
Rideshare drivers get weekly earnings summaries (HB 861)
Transportation network companies must provide drivers (“operators”) with a weekly fare and earnings summary. The law also requires annual reporting to the Maryland Public Service Commission, including trip and earnings information, with confidentiality protections for that report.
Health care and insurance changes
No prior authorization for transfers to special pediatric hospitals (HB 1301)
Maryland’s Medical Assistance Program, the Maryland Children’s Health Program, managed care organizations, and certain private insurers are barred from requiring prior authorization when a child is transferred to a special pediatric hospital.
Cancer screening coverage for professional firefighters (HB 459 / SB 374)
Counties that operate self-insured employee health benefit plans must provide preventive cancer screening coverage for county firefighters, with no copay, deductible, or coinsurance. The law also allows counties to meet the requirement through a no-cost annual exam or by applying for grant funding for screening technologies, and it directs a statewide study with a report due by Dec. 1, 2028.
Coverage access for referred out-of-network specialists (HB 11 / SB 902)
Maryland repeals the prior end date for certain rules involving referrals and reimbursement for specialists and certain nonphysician specialists who are not in a carrier’s provider panel, and limits extra utilization review in certain circumstances. (Listed as “Section 1 only.”)
Insurers can’t put time limits on anesthesia coverage (HB 1086)
If coverage is provided for anesthesia ordered by a licensed medical professional, insurers and certain programs must cover anesthesia for the full duration of the procedure, and cannot enforce policies that place time limits on delivery of anesthesia.
Required coverage for coronary calcium score testing (HB 666 / SB 60)
Maryland will require coverage for calcium score testing consistent with the most recent American College of Cardiology guidelines, and applies the rule to policies and plans issued, delivered, or renewed on or after Jan. 1, 2026.
“Fail-first” step therapy prohibited for insulin (HB 970 / SB 646)
Insurers and certain plans may not require step-therapy or fail-first protocols for insulin or insulin analogs used to treat Type 1, Type 2, or gestational diabetes.
More expenses must count toward prescription drug cost-sharing totals (SB 773)
Certain insurers and plans must include specified discounts, assistance payments, vouchers, and other out-of-pocket expenses when calculating cost-sharing contributions for certain prescription drugs. A violation is treated as a Consumer Protection Act violation.
Step-therapy limits for drugs treating symptoms tied to stage 4 metastatic cancer (HB 1087 / SB 921)
Insurers and certain plans may not impose step-therapy/fail-first rules for certain prescription drugs used to treat symptoms or side effects tied to treatment of stage four metastatic cancer, when consistent with best practices.
Oncology specialty drug coverage at qualified in-network providers (SB 975 / HB 1243)
Insurers and certain plans may not exclude coverage for certain specialty drugs when administered or dispensed by qualified in-network oncology providers that comply with state rules.
Adult hearing aid coverage expanded (HB 1355 / SB 641)
Health plans must cover medically appropriate and necessary hearing aids for adults when the hearing aid is ordered, fitted, and dispensed by a licensed hearing aid dispenser.
Extra notice required for cancellation/nonrenewal of small-group health plans (HB 936)
Carriers must provide electronic notice in addition to written notice when canceling or not renewing a small-group market health benefit plan, and must include information about additional coverage options.
Worker protections
Home-care workers must be employees for agencies to receive reimbursement (HB 39 / SB 197)
The Maryland Department of Health may reimburse a residential service agency for personal assistance services only if the services are provided by a worker classified as an employee (not an independent contractor).
Taxes and state finance
Digital advertising gross revenues tax: appeals and corrections process (HB 546 / SB 605)
Maryland establishes an appeal process for digital advertising gross revenues tax assessments and authorizes the Comptroller (or designee) to correct erroneous assessments under certain conditions. The changes apply to assessments made after Dec. 31, 2025.
Budget Reconciliation and Financing Act: partial effective date (HB 352)
One portion of the Budget Reconciliation and Financing Act of 2025 (“Section 5 only”) takes effect Jan. 1, 2026, and the summary indicates it includes multiple state finance changes, including adjustments involving income tax rates/brackets for certain income.
