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§ 15-1636. Cancellation or reversal of therapeutic interchange

West's Annotated Code of MarylandInsuranceEffective: October 1, 2008

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 16. Pharmacy Benefits Managers (Refs & Annos)
Part VI. Therapeutic Interchanges
Effective: October 1, 2008
MD Code, Insurance, § 15-1636
§ 15-1636. Cancellation or reversal of therapeutic interchange
In general
(a) A pharmacy benefits manager or its agent shall cancel and reverse a therapeutic interchange on written or verbal instructions from a prescriber, the beneficiary, or the beneficiary's representative.
Duties of pharmacy benefits manager or its agent
(b) If a therapeutic interchange is reversed, the pharmacy benefits manager or its agent shall:
(1) obtain a prescription for and dispense the originally prescribed prescription drug; and
(2) charge the beneficiary no more than one copayment.
Therapeutic interchanges occurring through a mail order pharmacy
(c) If the therapeutic interchange occurred through a mail order pharmacy and a beneficiary will exhaust an existing supply of the originally prescribed prescription drug before a replacement shipment will arrive to the beneficiary, the pharmacy benefits manager or its agent shall arrange for dispensing of an appropriate quantity of replacement prescription drugs at a local community pharmacy at no additional cost to the beneficiary.
Beneficiaries unwilling to pay higher copayment or coinsurance
(d) A pharmacy benefits manager or its agent may not be required to cancel and reverse a therapeutic interchange if a beneficiary is unwilling to pay a higher copayment or coinsurance associated with the originally prescribed prescription drug.

Credits

Added by Acts 2008, c. 203, § 1, eff. Oct. 1, 2008; Acts 2008, c. 204, § 1, eff. Oct. 1, 2008.
MD Code, Insurance, § 15-1636, MD INSURANCE § 15-1636
Current through legislation effective through April 25, 2024, from the 2024 Regular Session of the General Assembly. Some statute sections may be more current, see credits for details.
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