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§ 15-850. Prior authorization requirement for an opioid antagonist

West's Annotated Code of MarylandInsuranceEffective: January 1, 2018

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 8. Required Health Insurance Benefits (Refs & Annos)
Effective: January 1, 2018
MD Code, Insurance, § 15-850
§ 15-850. Prior authorization requirement for an opioid antagonist
Opioid antagonist defined
(a) In this section, “opioid antagonist” means:
(1) naloxone hydrochloride; or
(2) any other similarly acting and equally safe drug approved by the federal Food and Drug Administration for the treatment of a drug overdose.
Scope of section
(b)(1) This section applies to:
(i) insurers and nonprofit health service plans that provide coverage for prescription drugs under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and
(ii) health maintenance organizations that provide coverage for prescription drugs under individual or group contracts that are issued or delivered in the State.
(2) An insurer, a nonprofit health service plan, or a health maintenance organization that provides coverage for prescription drugs through a pharmacy benefits manager is subject to the requirements of this section.
In general
(c) An entity subject to this section that includes on its formulary an opioid antagonist may apply a prior authorization requirement for an opioid antagonist only if the entity provides coverage for at least one formulation of the opioid antagonist without a prior authorization requirement.

Credits

Added by Acts 2017, c. 571, § 4, eff. Jan. 1, 2018; Acts 2017, c. 572, § 4, eff. Jan. 1, 2018.
MD Code, Insurance, § 15-850, MD INSURANCE § 15-850
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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