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§ 15-1628.3. Pharmacy benefits manager or carrier; prohibited activities

West's Annotated Code of MarylandInsuranceEffective: January 1, 2022

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 15. Health Insurance
Subtitle 16. Pharmacy Benefits Managers (Refs & Annos)
Part V. Contracts with Pharmacies and Pharmacists; Audits
Effective: January 1, 2022
MD Code, Insurance, § 15-1628.3
§ 15-1628.3. Pharmacy benefits manager or carrier; prohibited activities
Fees or reimbursement related to the adjudication of a claim or an incentive program
(a) A pharmacy benefits manager or a carrier may not directly or indirectly charge a contracted pharmacy, or hold a contracted pharmacy responsible for, a fee or performance-based reimbursement related to the adjudication of a claim or an incentive program.
Reduction in payment for pharmacy services under reconciliation process
(b) A pharmacy benefits manager or carrier may not make or allow any reduction in payment for pharmacy services by a pharmacy benefits manager or carrier or directly or indirectly reduce a payment for a pharmacy service under a reconciliation process to an effective rate of reimbursement, including generic effective rates, brand effective rates, direct and indirect remuneration fees, or any other reduction or aggregate reduction of payments.

Credits

Added by Acts 2019, c. 400, § 1, eff. May 13, 2019. Amended by Acts 2020, c. 455, § 1, eff. Jan. 1, 2021; Acts 2021, c. 358, § 1, eff. Jan. 1, 2022.
MD Code, Insurance, § 15-1628.3, MD INSURANCE § 15-1628.3
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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