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§ 19-712.2. Changes requiring advance notice

West's Annotated Code of MarylandHealth--General

West's Annotated Code of Maryland
Health--General
Title 19. Health Care Facilities (Refs & Annos)
Subtitle 7. Health Maintenance Organizations (Refs & Annos)
MD Code, Health - General, § 19-712.2
§ 19-712.2. Changes requiring advance notice
Currentness
Pharmaceutical benefits
(a) A health maintenance organization that provides pharmaceutical benefits shall notify all pharmacies under contract with the health maintenance organization in writing of changes in the pharmaceutical benefit program rules or requirements at least 30 days before the change is effective.
Changes requiring advance notice
(b) Changes that require 30 days' advance written notice under subsection (a) of this section are:
(1) Exclusion of coverage for classes of drugs as specified by contract;
(2) Changes in prior or preauthorization procedures; and
(3) Selection of new prescription claims processors.
Failure to provide advance notice
(c) A health maintenance organization that fails to provide advance notice as required under subsection (a) 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 1992, c. 521, § 1, eff. Oct. 1, 1992.
MD Code, Health - General, § 19-712.2, MD HEALTH GEN § 19-712.2
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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