---
type: "Bill"
title: "Health Insurance – Step Therapy or Fail–First Protocol – Revisions"
description: "Health Insurance – Step Therapy or Fail–First Protocol – Revisions"
jurisdiction: "us/states/md"
legislature: "Maryland General Assembly"
session: "2023"
identifier: "SB 515"
citation: "Maryland SB 515 (2023)"
classification: ["bill"]
subjects: []
status: "enacted"
primary_sponsors: ["Lam"]
version_count: 3
action_count: 13
vote_count: 0
first_action: "2023-02-03"
last_action: "2023-05-03"
source: "openstates"
source_identifier: "ocd-bill/1c486c84-5ef6-458e-ad88-e074e7236737"
source_url: "http://mgaleg.maryland.gov/mgawebsite/Legislation/Details/sb0515?ys=2023RS&search=True"
source_hash: "4b4cab43c076e297dd5eb2612ad0af91dd17b8e9ee7feddd4973b2c722cdd573"
vintage: "2026-07-01"
source_snapshot: "https://data.openstates.org/daily/2026-07-01/public.pgdump"
retrieved_at: "2026-07-06"
confidence: "reported"
tags: ["legislation", "bill", "us-md"]
---

# Maryland SB 515 (2023) — Health Insurance – Step Therapy or Fail–First Protocol – Revisions

## Version chain

The bill's text revisions, in order — the diff chain from filing to enrollment.

1. **Chapter - Health Insurance – Step Therapy or Fail–First Protocol – Revisions** (committee substitute) — [source](http://mgaleg.maryland.gov/2023RS/Chapters_noln/CH_364_sb0515t.pdf)
2. **First - Health Insurance – Step Therapy or Fail–First Protocol – Revisions** (committee substitute) — [source](http://mgaleg.maryland.gov/2023RS/bills/sb/sb0515f.pdf)
3. **Third - Health Insurance – Step Therapy or Fail–First Protocol – Revisions** (committee substitute) — [source](http://mgaleg.maryland.gov/2023RS/bills/sb/sb0515t.pdf)

## Sponsors

- Lam — primary (person)

## Timeline

The legislative action history — every referral, reading, and vote.

- **2023-02-03** First Reading Finance `referral-committee`
- **2023-02-03** Hearing 2/22 at 1:00 p.m.
- **2023-03-20** Favorable with Amendments Report by Finance `committee-passage-favorable`
- **2023-03-20** Favorable with Amendments { `committee-passage-favorable`
- **2023-03-20** Second Reading Passed with Amendments
- **2023-03-20** Third Reading Passed `passage`
- **2023-03-21** Referred Health and Government Operations `referral-committee`
- **2023-03-22** Hearing 3/30 at 1:00 p.m.
- **2023-03-31** Favorable Report by Health and Government Operations `committee-passage-favorable`
- **2023-03-31** Favorable Adopted Second Reading Passed `committee-passage-favorable`
- **2023-04-05** Third Reading Passed `passage`
- **2023-04-06** Returned Passed
- **2023-05-03** Approved by the Governor - Chapter 364 `executive-signature`

## Source

OpenStates / OpenCivicData bulk snapshot [2026-07-01](https://data.openstates.org/daily/2026-07-01/public.pgdump); origin `ocd-bill/1c486c84-5ef6-458e-ad88-e074e7236737`. Confidence: reported (aggregated from official Maryland legislature records).