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SB 926

State Medicaid program; requiring coverage of insulin and insulin delivery systems; specifying certain covered system. Effective date. Emergency.

2025 Regular Session Introduced by Carri Hicks

Establishes a regulated process for terminally ill adults to request and obtain self-administered aid in dying, with safeguards, documentation, and liability protections.

Second Reading referred to Health and Human Services Committee then to Appropriations Committee
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Bill Summary · SB 926

Summary — SB 926: End‑of‑Life Option Act

(The Honorable Elijah E. Cummings and the Honorable Shane E. Pendergrass Act)

Status: Hearing canceled. Introduced: January 24, 2025.

Purpose / Intent

SB 926 establishes a regulated statutory process by which a competent, terminally ill adult may request and receive a prescription for self‑administered medication to hasten death ("aid in dying"). The bill creates eligibility criteria, procedural safeguards (multiple requests, waiting periods, consultations), provider and pharmacist protections, documentation and reporting requirements, and limited enforcement and penalty provisions. It also clarifies that compliance with the Act will not constitute criminal assisted suicide and treats death by self‑administration under the Act as a natural death for certain legal/insurance purposes.

Key definitions

  • Qualified individual: an adult who (1) has capacity to make medical decisions, (2) has a terminal illness, and (3) can self‑administer medication.
  • Attending physician: the physician with primary responsibility for the person’s terminal care.
  • Consulting physician: a licensed physician qualified by specialty/experience to confirm diagnosis and prognosis.
  • Licensed mental health professional: a licensed psychiatrist or licensed psychologist.

Core procedural safeguards and requirements

  • Requests: A patient must make an initial oral request, then a written request on a specified form (signed by the patient and two witnesses with limitations on who may serve as witnesses), and a second oral request. At least 15 days must elapse after the initial oral request, and at least 48 hours after the written request before the second oral request. At least one oral request must occur with the patient alone with the attending physician.
  • Confirmation: The attending physician must determine the patient is qualified, informed, and acting voluntarily. The attending must refer the patient to a consulting physician to confirm diagnosis/prognosis and, where indicated, to a licensed mental health professional for assessment of decision‑making capacity. Aid in dying cannot proceed until any required mental health assessment confirms capacity.
  • Counseling: The attending must inform the patient of diagnosis, prognosis, risks of the medication, probable result, and feasible alternatives (including palliative care and hospice), and must assess coercion or undue influence.

Provider, pharmacist and facility provisions

  • Voluntary participation: Physician, pharmacist, and other providers may decline to participate. A nonparticipating attending must assist with transfer of care if requested.
  • Dispensing: An attending physician with a dispensing permit may dispense the medication; otherwise the prescription may be filled by a pharmacist. A pharmacist may refuse to dispense but must notify the patient, attending physician, and any identified agent. Dispensing is restricted to the qualified individual, the attending, or an expressly identified agent.
  • Facility policies and insurance: The bill addresses health‑care facility policies (allowing facilities to set practices consistent with law) and specifies that qualifying deaths are treated as natural causes for relevant legal and insurance purposes; the Maryland Insurance Commissioner is authorized to enforce certain insurance provisions.

Documentation, reporting, and confidentiality

  • The attending must document in the medical record: the basis for adult status, all oral/written requests, diagnoses, counseling provided, and other required determinations. The bill creates statutory reporting and recordkeeping requirements. (Text indicates some protections against certain forms of discovery for these records; consult full bill for details.)

Criminal penalties, liability protection, severability

  • The bill exempts licensed physicians and other covered providers from civil/criminal liability when they comply with the Act’s safeguards. It establishes criminal penalties for specified violations (details in bill). Provisions are severable.

Fiscal impact

  • State general fund: one‑time contractual cost up to $750,000 in FY2026 to develop a reporting system for physician submissions; ongoing maintenance estimated at about $50,000 annually thereafter. Penalty provisions are not expected to materially affect state or local finances.

Who is affected

  • Eligible patients (terminally ill, competent adults) and their families/agents; attending and consulting physicians; licensed mental health professionals; pharmacists; health‑care facilities and insurers; state agencies (for reporting and enforcement).

Procedural / timeline notes

  • Introduced Jan 24, 2025. Status shown as "Hearing canceled." The bill text contains severability language and cross‑references to relevant criminal, health, and insurance code provisions. For full legal requirements, liability details, and any amendments, consult the enrolled bill or official legislative text.

Compiled from official sources — confirm details with the bill’s official record.

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