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§ 15-107. Notice to pharmacies of change in pharmaceutical benefits

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 1. General Provisions (Refs & Annos)
MD Code, Insurance, § 15-107
§ 15-107. Notice to pharmacies of change in pharmaceutical benefits
Currentness
Application of section
(a) This section applies to insurers and nonprofit health service plans that issue or deliver individual, group, or blanket health insurance policies in the State.
Changes in rules or requirements
(b) At least 30 days before the change is effective, an entity subject to this section that provides pharmaceutical benefits shall notify in writing all pharmacies under contract with the entity of any of the following changes in the pharmaceutical benefit program rules or requirements:
(1) exclusion of coverage for classes of drugs as specified by the contract;
(2) changes in prior or preauthorization procedures; or
(3) selection of new prescription claims processors.
Failure of entity to provide notice
(c) An entity subject to this section that fails to provide advance notice under subsection (b) of this section shall honor and pay in full any claim under the program rules or requirements that existed before the change for 30 days after the postmarked date of the notice.

Credits

Added by Acts 1997, c. 35, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, §§ 361H, 468-I, 476A.
MD Code, Insurance, § 15-107, MD INSURANCE § 15-107
Current through legislation effective through April 9, 2023, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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