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§ 8-313. Notice to pharmacies of change in pharmaceutical benefits

West's Annotated Code of MarylandInsurance

West's Annotated Code of Maryland
Insurance (Refs & Annos)
Title 8. Entities that Act as Insurers
Subtitle 3. Third Party Administrators (Refs & Annos)
MD Code, Insurance, § 8-313
§ 8-313. Notice to pharmacies of change in pharmaceutical benefits
Currentness
In general
(a) At least 30 days before the change is effective, an administrator of a plan that provides pharmaceutical benefits shall notify in writing all pharmacies under contract with the plan 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 contract;
(2) changes in prior or preauthorization procedures; or
(3) selection of new prescription claims processors.
Failure to provide notice
(b) An administrator that fails to provide advance notice 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 1995, c. 36, § 1, eff. Oct. 1, 1997. Amended by Acts 1997, c. 57, § 2, eff. Oct. 1, 1997.
Formerly Art. 48A, § 697.
MD Code, Insurance, § 8-313, MD INSURANCE § 8-313
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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