EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
*hb0229*
HOUSE BILL 229
J2, J1 2lr1027
CF SB 19
By: Delegates K. Young, Belcastro, Forbes, Healey, McComas, Reznik, and Ruth
Introduced and read first time: January 13, 2022
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 2, 2022
CHAPTER ______
AN ACT concerning 1
Pharmacists – Administration of Maintenance Injectable Medications – 2
Medications for Treatment of Sexually Transmitted Infections 3
FOR the purpose of altering the definition of “maintenance injectable medication” for the 4
purposes of provisions of law governing the administration of maintenance injectable 5
medications by pharmacists to include a medication that treats a sexually 6
transmitted infection and is not a vaccine defining “injectable medications for 7
treatment of sexually transmitted infections” for the purposes of authorizing 8
pharmacists to administer the medications; requiring certain insurers, nonprofit 9
health service plans, health maintenance organizations, the Maryland Medical 10
Assistance Program, and the Maryland Children’s Health Program to provide certain 11
coverage for the administration of the medication by a pharmacist; and generally 12
relating to the administration of maintenance injectable medications by 13
pharmacists. 14
BY repealing and reenacting, with amendments, 15
Article – Health Occupations 16
Section 12–101(o–1) 17
Annotated Code of Maryland 18
(2021 Replacement Volume) 19
BY repealing and reenacting, with amendments, 20
Article – Health – General 21
Section 15–148(c) 22
Annotated Code of Maryland 23 2 HOUSE BILL 229
(2019 Replacement Volume and 2021 Supplement) 1
BY adding to 2
Article – Health Occupations 3
Section 12–101(l–1) 4
Annotated Code of Maryland 5
(2021 Replacement Volume) 6
BY repealing and reenacting, without with amendments, 7
Article – Health Occupations 8
Section 12–509(a) and (b) 12–509 9
Annotated Code of Maryland 10
(2021 Replacement Volume) 11
BY repealing and reenacting, with amendments, 12
Article – Insurance 13
Section 15–716 14
Annotated Code of Maryland 15
(2017 Replacement Volume and 2021 Supplement) 16
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLA ND, 17
That the Laws of Maryland read as follows: 18
Article – Health – General 19
15–148. 20
(c) The Program and the Maryland Children’s Health Program shall provide 21
coverage for services, to the same extent as services rendered by any other licensed health 22
care practitioner, rendered to an enrollee by a licensed pharmacist under: 23
(1) § 12–509 of the Health Occupations Article in administering 24
self–administered medications [or], maintenance injectable medications, OR INJECTABLE 25
MEDICATIONS FOR TREA TMENT OF SEX UALLY TRANSMITTED IN FECTIONS; or 26
(2) § 12–511 of the Health Occupations Article in screening an enrollee and 27
prescribing contraceptives for the enrollee. 28
Article – Health Occupations 29
12–101. 30
(o–1) (1) “Maintenance injectable medication” means a medication that: 31
(i) Is administered by injection other than intravenously; and 32
(ii) 1. Treats a chronic need, condition, or disorder; OR 33 HOUSE BILL 229 3
2. TREATS A SEXUALLY TRA NSMITTED INFECTION A ND 1
IS NOT A VACCINE. 2
(2) “Maintenance injectable medication” includes a medication for the 3
treatment of a psychiatric disorder or substance use disorder, contraception, and vitamins. 4
(L–1) “INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY 5
TRANSMITTED INFECTIO N” MEANS A MEDICATION T HAT: 6
(1) IS ADMINISTERED BY IN JECTION OTHER THAN I NTRAVENOUSLY ; 7
(2) TREATS A SEXUALLY TRA NSMITTED INFECTION ; AND 8
(3) IS NOT A VACCINE. 9
12–509. 10
(a) In addition to the authority granted to a pharmacist under § 12–508 of this 11
subtitle, a pharmacist, in accordance with regulations adopted by the Board, may 12
administer: 13
(1) A self–administered drug to a patient that is prescribed by an 14
authorized prescriber; and 15
(2) Subject to subsection (b) of this section, a maintenance injectable 16
medication OR AN INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY 17
TRANSMITTED INFECTIO N that is not a biological product to a patient: 18
(i) That is prescribed by an authorized prescriber; 19
(ii) In accordance with a standing order issued by an authorized 20
public health official; or 21
(iii) In accordance with a protocol under Subtitle 6A of this title. 22
(b) A pharmacist may not administer an initial dose of a maintenance injectable 23
medication product OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY 24
TRANSMITTED INFECTION under subsection (a)(2) of this section unless the pharmacist 25
receives written approval from the prescriber. 26
(c) (1) On or before September 1, 2021, the Board, in consultation with the 27
State Board of Physicians and the State Board of Nursing, shall adopt regulations 28
establishing standard procedures: 29
4 HOUSE BILL 229
(i) For notifying a patient about payment for services before the 1
pharmacist administers a maintenance injectable medication OR AN INJECTABLE 2
MEDICATION FOR TREAT MENT OF A SEXUALLY T RANSMITTED INFECTION; 3
(ii) That a pharmacist must use to administer [a]: 4
1. A maintenance injectable medication after an initial dose 5
is administered by the prescriber; OR 6
2. AN INJECTABLE MEDICAT ION FOR TREATMENT OF A 7
SEXUALLY TRANSMITTED INFECTION; 8
(iii) That a pharmacist must use to administer an initial dose of a 9
maintenance injectable medication OR AN INJECTABLE MED ICATION FOR TREATMEN T 10
OF A SEXUALLY TRANSM ITTED INFECTION if the administration of the initial dose is 11
authorized under subsection (b) of this section; and 12
(iv) For communicating to the prescriber whether a medication was 13
administered to a specific patient and relevant information about the patient’s condition. 14
(2) The regulations shall require a pharmacist to: 15
(i) Except as provided in paragraph (3) of this subsection, complete 16
a training program approved by the Board for: 17
1. Administering maintenance injectable medications AND 18
INJECTABLE MEDICATIO NS FOR TREATMENT OF A SEXUALLY TRANSMITT ED 19
INFECTION; and 20
2. Managing the populations the pharmacist serves, the 21
medications being administered, and the current guidelines relating to these populations 22
and medications; 23
(ii) Follow the standard procedures established by the Board; and 24
(iii) After administering a maintenance injectable medication OR AN 25
INJECTABLE MEDICATIO N FOR TREATMENT OF A SEXUALLY TRANSMITTED 26
INFECTION: 27
1. Notify the prescriber that the maintenance injectable 28
medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXU ALLY 29
TRANSMITTED INFECTIO N was administered and of any relevant details about the 30
patient’s condition; 31
HOUSE BILL 229 5
2. Provide the patient with a written record of the 1
maintenance injectable medication OR INJECTABLE MEDICA TION FOR TREATMENT O F 2
A SEXUALLY TRANSMITT ED INFECTION administered; 3
3. Record in any electronic or written health record on the 4
patient maintained by the pharmacist: 5
A. The administering of the maintenance injectable 6
medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY 7
TRANSMITTED INFECTION ; and 8
B. Any pertinent details about the patient’s condition; and 9
4. Notify the patient of the need to attend any upcoming 10
appointments the patient has scheduled with the prescriber. 11
(3) The regulations shall waive the requirement to complete a training 12
program for a pharmacist who already has undergone the training as part of the 13
pharmacist’s formal educational program. 14
Article – Insurance 15
15–716. 16
(a) This section applies to individual, group, or blanket health insurance policies 17
and contracts delivered or issued for delivery in the State by insurers, nonprofit health 18
service plans, and health maintenance organizations that provide coverage for patient 19
assessment regarding, and administration of, self–administered medications [and], 20
maintenance injectable medications, AND INJECTABLE MEDIC ATIONS FOR TREATMENT 21
OF SEXUALLY TRANSMIT TED INFECTIONS . 22
(b) An entity subject to this section shall provide coverage for services rendered 23
by a licensed pharmacist under § 12–509 of the Health Occupations Article to an individual 24
who is covered under a policy or contract issued or delivered by the entity, to the same 25
extent as services rendered by any other licensed health care practitioner, for patient 26
assessment regarding and in administering self –administered medications [or], 27
maintenance injectable medications, OR INJECTABLE MEDICA TIONS FOR TREATMENT 28
OF SEXUALLY TRANSMIT TED INFECTIONS . 29
SECTION 2. AND BE IT FURTHER ENACTED, That, to the extent determined 30
appropriate by the State Board of Pharmacy, the regulations adopted by the State Board of 31
Pharmacy, in consultation with the State Board of Physicians and the State Board of 32
Nursing, under § 12–509 of the Health Occupations Article, as enacted by Chapters 757 33
and 758 of the Acts of 2021, for the administration of maintenance injectable medications 34
by a pharmacist shall be the same regulations for the administration of injectable 35 6 HOUSE BILL 229
medications for treatment of sexually transmitted infections by a pharmacist adopted in 1
accordance with § 12–509 of the Health Occupations Article, as enacted by this Act. 2
SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
October 1, 2022. 4
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.