MD
Maryland House Bill HB229

Maryland 2022 Regular Session

Maryland House Bill HB229 Compare Versions

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1- LAWRENCE J. HOGAN, JR., Governor Ch. 719
21
3-– 1 –
4-Chapter 719
5-(House Bill 229)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
4+ [Brackets] indicate matter deleted from existing law.
5+ Underlining indicates amendments to bill.
6+ Strike out indicates matter stricken from the bill by amendment or deleted from the law by
7+amendment.
8+ *hb0229*
89
9-Pharmacists – Administration of Maintenance Injectable Medications –
10-Medications for Treatment of Sexually Transmitted Infections
10+HOUSE BILL 229
11+J2, J1 2lr1027
12+ CF SB 19
13+By: Delegates K. Young, Belcastro, Forbes, Healey, McComas, Reznik, and Ruth
14+Introduced and read first time: January 13, 2022
15+Assigned to: Health and Government Operations
16+Committee Report: Favorable with amendments
17+House action: Adopted
18+Read second time: March 2, 2022
1119
12-FOR the purpose of altering the definition of “maintenance injectable medication” for the
13-purposes of provisions of law governing the administration of maintenance injectable
14-medications by pharmacists to include a medication that treats a sexually
15-transmitted infection and is not a vaccine defining “injectable medications for
16-treatment of sexually transmitted infections” for the purposes of authorizing
17-pharmacists to administer the medications; requiring certain insurers, nonprofit
18-health service plans, health maintenance organizations, the Maryland Medical
19-Assistance Program, and the Maryland Children’s Health Program to provide certain
20-coverage for the administration of the medication by a pharmacist; and generally
21-relating to the administration of maintenance injectable medications by
22-pharmacists.
20+CHAPTER ______
2321
24-BY repealing and reenacting, with amendments,
25- Article – Health Occupations
26-Section 12–101(o–1)
27- Annotated Code of Maryland
28- (2021 Replacement Volume)
22+AN ACT concerning 1
2923
30-BY repealing and reenacting, with amendments,
31- Article – Health – General
32- Section 15–148(c)
33- Annotated Code of Maryland
34- (2019 Replacement Volume and 2021 Supplement)
24+Pharmacists – Administration of Maintenance Injectable Medications – 2
25+Medications for Treatment of Sexually Transmitted Infections 3
3526
36-BY adding to
37- Article – Health Occupations
38- Section 12–101(l–1)
39- Annotated Code of Maryland
40- (2021 Replacement Volume)
27+FOR the purpose of altering the definition of “maintenance injectable medication” for the 4
28+purposes of provisions of law governing the administration of maintenance injectable 5
29+medications by pharmacists to include a medication that treats a sexually 6
30+transmitted infection and is not a vaccine defining “injectable medications for 7
31+treatment of sexually transmitted infections” for the purposes of authorizing 8
32+pharmacists to administer the medications; requiring certain insurers, nonprofit 9
33+health service plans, health maintenance organizations, the Maryland Medical 10
34+Assistance Program, and the Maryland Children’s Health Program to provide certain 11
35+coverage for the administration of the medication by a pharmacist; and generally 12
36+relating to the administration of maintenance injectable medications by 13
37+pharmacists. 14
4138
42-BY repealing and reenacting, without with amendments,
43- Article – Health Occupations
44-Section 12–509(a) and (b) 12–509
45- Annotated Code of Maryland
46- (2021 Replacement Volume)
39+BY repealing and reenacting, with amendments, 15
40+ Article – Health Occupations 16
41+Section 12–101(o–1) 17
42+ Annotated Code of Maryland 18
43+ (2021 Replacement Volume) 19
4744
48-BY repealing and reenacting, with amendments,
49- Article – Insurance Ch. 719 2022 LAWS OF MARYLAND
45+BY repealing and reenacting, with amendments, 20
46+ Article – Health – General 21
47+ Section 15–148(c) 22
48+ Annotated Code of Maryland 23 2 HOUSE BILL 229
5049
51-– 2 –
52- Section 15–716
53- Annotated Code of Maryland
54- (2017 Replacement Volume and 2021 Supplement)
5550
56- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
57-That the Laws of Maryland read as follows:
51+ (2019 Replacement Volume and 2021 Supplement) 1
5852
59-Article – Health – General
53+BY adding to 2
54+ Article – Health Occupations 3
55+ Section 12–101(l–1) 4
56+ Annotated Code of Maryland 5
57+ (2021 Replacement Volume) 6
6058
61-15–148.
59+BY repealing and reenacting, without with amendments, 7
60+ Article – Health Occupations 8
61+Section 12–509(a) and (b) 12–509 9
62+ Annotated Code of Maryland 10
63+ (2021 Replacement Volume) 11
6264
63- (c) The Program and the Maryland Children’s Health Program shall provide
64-coverage for services, to the same extent as services rendered by any other licensed health
65-care practitioner, rendered to an enrollee by a licensed pharmacist under:
65+BY repealing and reenacting, with amendments, 12
66+ Article – Insurance 13
67+ Section 15–716 14
68+ Annotated Code of Maryland 15
69+ (2017 Replacement Volume and 2021 Supplement) 16
6670
67- (1) § 12–509 of the Health Occupations Article in administering
68-self–administered medications [or], maintenance injectable medications, OR INJECTABLE
69-MEDICATIONS FOR TREA TMENT OF SEXUALLY TRANSMIT TED INFECTIONS ; or
71+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLA ND, 17
72+That the Laws of Maryland read as follows: 18
7073
71- (2) § 12–511 of the Health Occupations Article in screening an enrollee and
72-prescribing contraceptives for the enrollee.
74+Article – Health – General 19
7375
74-Article – Health Occupations
76+15–148. 20
7577
76-12–101.
78+ (c) The Program and the Maryland Children’s Health Program shall provide 21
79+coverage for services, to the same extent as services rendered by any other licensed health 22
80+care practitioner, rendered to an enrollee by a licensed pharmacist under: 23
7781
78- (o–1) (1) “Maintenance injectable medication” means a medication that:
82+ (1) § 12–509 of the Health Occupations Article in administering 24
83+self–administered medications [or], maintenance injectable medications, OR INJECTABLE 25
84+MEDICATIONS FOR TREA TMENT OF SEX UALLY TRANSMITTED IN FECTIONS; or 26
7985
80- (i) Is administered by injection other than intravenously; and
86+ (2) § 12–511 of the Health Occupations Article in screening an enrollee and 27
87+prescribing contraceptives for the enrollee. 28
8188
82- (ii) 1. Treats a chronic need, condition, or disorder; OR
89+Article – Health Occupations 29
8390
84- 2. TREATS A SEXUALLY TRA NSMITTED INFECTION A ND
85-IS NOT A VACCINE .
91+12–101. 30
8692
87- (2) “Maintenance injectable medication” includes a medication for the
88-treatment of a psychiatric disorder or substance use disorder, contraception, and vitamins.
93+ (o–1) (1) “Maintenance injectable medication” means a medication that: 31
8994
90- (L–1) “INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY
91-TRANSMITTED INFECTIO N” MEANS A MEDICATION T HAT:
95+ (i) Is administered by injection other than intravenously; and 32
9296
93- (1) IS ADMINISTERED BY IN JECTION OTHER THAN I NTRAVENOUSLY ;
97+ (ii) 1. Treats a chronic need, condition, or disorder; OR 33 HOUSE BILL 229 3
9498
95- (2) TREATS A SEXUALLY TRA NSMITTED INFECTION ; AND
96- LAWRENCE J. HOGAN, JR., Governor Ch. 719
9799
98-– 3 –
99- (3) IS NOT A VACCINE.
100100
101-12–509.
101+ 2. TREATS A SEXUALLY TRA NSMITTED INFECTION A ND 1
102+IS NOT A VACCINE. 2
102103
103- (a) In addition to the authority granted to a pharmacist under § 12–508 of this
104-subtitle, a pharmacist, in accordance with regulations adopted by the Board, may
105-administer:
104+ (2) “Maintenance injectable medication” includes a medication for the 3
105+treatment of a psychiatric disorder or substance use disorder, contraception, and vitamins. 4
106106
107- (1) A self–administered drug to a patient that is prescribed by an
108-authorized prescriber; and
107+ (L–1) “INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY 5
108+TRANSMITTED INFECTIO N” MEANS A MEDICATION T HAT: 6
109109
110- (2) Subject to subsection (b) of this section, a maintenance injectable
111-medication OR AN INJEC TABLE MEDICATION FOR TREATMENT OF A SEXUA LLY
112-TRANSMITTED INFECTIO N that is not a biological product to a patient:
110+ (1) IS ADMINISTERED BY IN JECTION OTHER THAN I NTRAVENOUSLY ; 7
113111
114- (i) That is prescribed by an authorized prescriber;
112+ (2) TREATS A SEXUALLY TRA NSMITTED INFECTION ; AND 8
115113
116- (ii) In accordance with a standing order issued by an authorized
117-public health official; or
114+ (3) IS NOT A VACCINE. 9
118115
119- (iii) In accordance with a protocol under Subtitle 6A of this title.
116+12–509. 10
120117
121- (b) A pharmacist may not administer an initial dose of a maintenance injectable
122-medication product OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY
123-TRANSMITTED INFE CTION under subsection (a)(2) of this section unless the pharmacist
124-receives written approval from the prescriber.
118+ (a) In addition to the authority granted to a pharmacist under § 12–508 of this 11
119+subtitle, a pharmacist, in accordance with regulations adopted by the Board, may 12
120+administer: 13
125121
126- (c) (1) On or before September 1, 2021, the Board, in consultation with the
127-State Board of Physicians and the State Board of Nursing, shall adopt regulations
128-establishing standard procedures:
122+ (1) A self–administered drug to a patient that is prescribed by an 14
123+authorized prescriber; and 15
129124
130- (i) For notifying a patient about payment for services before the
131-pharmacist administers a maintenance injectable medication OR AN INJECTABLE
132-MEDICATION FOR TREAT MENT OF A SEXUALLY T RANSMITTED INFECTION;
125+ (2) Subject to subsection (b) of this section, a maintenance injectable 16
126+medication OR AN INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY 17
127+TRANSMITTED INFECTIO N that is not a biological product to a patient: 18
133128
134- (ii) That a pharmacist must use to administer [a]:
129+ (i) That is prescribed by an authorized prescriber; 19
135130
136- 1. A maintenance injectable medication after an initial dose
137-is administered by the prescriber; OR
131+ (ii) In accordance with a standing order issued by an authorized 20
132+public health official; or 21
138133
139- 2. AN INJECTABLE MEDICAT ION FOR TREATMENT OF A
140-SEXUALLY TRANSMITTED INFECTION;
134+ (iii) In accordance with a protocol under Subtitle 6A of this title. 22
141135
142- (iii) That a pharmacist must use to administer an initial dose of a
143-maintenance injectable medication OR AN INJECTABLE MED ICATION FOR TREATMEN T Ch. 719 2022 LAWS OF MARYLAND
136+ (b) A pharmacist may not administer an initial dose of a maintenance injectable 23
137+medication product OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY 24
138+TRANSMITTED INFECTION under subsection (a)(2) of this section unless the pharmacist 25
139+receives written approval from the prescriber. 26
144140
145-– 4 –
146-OF A SEXUALLY TRANSM ITTED INFECTION if the administration of the initial dose is
147-authorized under subsection (b) of this section; and
141+ (c) (1) On or before September 1, 2021, the Board, in consultation with the 27
142+State Board of Physicians and the State Board of Nursing, shall adopt regulations 28
143+establishing standard procedures: 29
144+ 4 HOUSE BILL 229
148145
149- (iv) For communicating to the prescriber whether a medication was
150-administered to a specific patient and relevant information about the patient’s condition.
151146
152- (2) The regulations shall require a pharmacist to:
147+ (i) For notifying a patient about payment for services before the 1
148+pharmacist administers a maintenance injectable medication OR AN INJECTABLE 2
149+MEDICATION FOR TREAT MENT OF A SEXUALLY T RANSMITTED INFECTION; 3
153150
154- (i) Except as provided in paragraph (3) of this subsection, complete
155-a training program approved by the Board for:
151+ (ii) That a pharmacist must use to administer [a]: 4
156152
157- 1. Administering maintenance injectable medications AND
158-INJECTABLE MEDICATIO NS FOR TREATMENT OF A SEXUALLY TRANSMITT ED
159-INFECTION; and
153+ 1. A maintenance injectable medication after an initial dose 5
154+is administered by the prescriber; OR 6
160155
161- 2. Managing the populations the pharmacist serves, the
162-medications being administered, and the current guidelines relating to these populations
163-and medications;
156+ 2. AN INJECTABLE MEDICAT ION FOR TREATMENT OF A 7
157+SEXUALLY TRANSMITTED INFECTION; 8
164158
165- (ii) Follow the standard procedures established by the Board; and
159+ (iii) That a pharmacist must use to administer an initial dose of a 9
160+maintenance injectable medication OR AN INJECTABLE MED ICATION FOR TREATMEN T 10
161+OF A SEXUALLY TRANSM ITTED INFECTION if the administration of the initial dose is 11
162+authorized under subsection (b) of this section; and 12
166163
167- (iii) After administering a maintenance injectable medication OR AN
168-INJECTABLE MEDICATIO N FOR TREATMENT OF A SEXUALLY TRANSMITTED
169-INFECTION:
164+ (iv) For communicating to the prescriber whether a medication was 13
165+administered to a specific patient and relevant information about the patient’s condition. 14
170166
171- 1. Notify the prescriber that the maintenance injectable
172-medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY
173-TRANSMITTED INFECTIO N was administered and of any relevant details about the
174-patient’s condition;
167+ (2) The regulations shall require a pharmacist to: 15
175168
176- 2. Provide the patient with a written record of the
177-maintenance injectable medication OR INJECTABLE MEDICATION FOR TREAT MENT OF
178-A SEXUALLY TRANSMITT ED INFECTION administered;
169+ (i) Except as provided in paragraph (3) of this subsection, complete 16
170+a training program approved by the Board for: 17
179171
180- 3. Record in any electronic or written health record on the
181-patient maintained by the pharmacist:
172+ 1. Administering maintenance injectable medications AND 18
173+INJECTABLE MEDICATIO NS FOR TREATMENT OF A SEXUALLY TRANSMITT ED 19
174+INFECTION; and 20
182175
183- A. The administering of the maintenance injectable
184-medication OR INJECTAB LE MEDICATION FOR TR EATMENT OF A SEXUALL Y
185-TRANSMITTED INFECTIO N; and
176+ 2. Managing the populations the pharmacist serves, the 21
177+medications being administered, and the current guidelines relating to these populations 22
178+and medications; 23
186179
187- B. Any pertinent details about the patient’s condition; and
180+ (ii) Follow the standard procedures established by the Board; and 24
188181
189- 4. Notify the patient of the need to attend any upcoming
190-appointments the patient has scheduled with the prescriber. LAWRENCE J. HOGAN, JR., Governor Ch. 719
182+ (iii) After administering a maintenance injectable medication OR AN 25
183+INJECTABLE MEDICATIO N FOR TREATMENT OF A SEXUALLY TRANSMITTED 26
184+INFECTION: 27
191185
192-– 5 –
186+ 1. Notify the prescriber that the maintenance injectable 28
187+medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXU ALLY 29
188+TRANSMITTED INFECTIO N was administered and of any relevant details about the 30
189+patient’s condition; 31
190+ HOUSE BILL 229 5
193191
194- (3) The regulations shall waive the requirement to complete a training
195-program for a pharmacist who already has undergone the training as part of the
196-pharmacist’s formal educational program.
197192
198-Article – Insurance
193+ 2. Provide the patient with a written record of the 1
194+maintenance injectable medication OR INJECTABLE MEDICA TION FOR TREATMENT O F 2
195+A SEXUALLY TRANSMITT ED INFECTION administered; 3
199196
200-15–716.
197+ 3. Record in any electronic or written health record on the 4
198+patient maintained by the pharmacist: 5
201199
202- (a) This section applies to individual, group, or blanket health insurance policies
203-and contracts delivered or issued for delivery in the State by insurers, nonprofit health
204-service plans, and health maintenance organizations that provide coverage for patient
205-assessment regarding, and administration of, self–administered medications [and],
206-maintenance injectable medications, AND INJECTABLE MEDIC ATIONS FOR TREATMENT
207-OF SEXUALLY TRANSMIT TED INFECTIONS .
200+ A. The administering of the maintenance injectable 6
201+medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY 7
202+TRANSMITTED INFECTION ; and 8
208203
209- (b) An entity subject to this section shall provide coverage for services rendered
210-by a licensed pharmacist under § 12–509 of the Health Occupations Article to an individual
211-who is covered under a policy or contract issued or delivered by the entity, to the same
212-extent as services rendered by any other licensed health care practitioner, for patient
213-assessment regarding and in administering self –administered medications [or],
214-maintenance injectable medications, OR INJECTABLE MEDICA TIONS FOR TREATMENT
215-OF SEXUALLY TRANSMIT TED INFECTIONS .
204+ B. Any pertinent details about the patient’s condition; and 9
216205
217- SECTION 2. AND BE IT FURTHER ENACTED, That, to the extent determined
218-appropriate by the State Board of Pharmacy, the regulations adopted by the State Board of
219-Pharmacy, in consultation with the State Board of Physicians and the State Board of
220-Nursing, under § 12–509 of the Health Occupations Article, as enacted by Chapters 757
221-and 758 of the Acts of 2021, for the administration of maintenance injectable medications
222-by a pharmacist shall be the same regulations for the administration of injectable
223-medications for treatment of sexually transmitted infections by a pharmacist adopted in
224-accordance with § 12–509 of the Health Occupations Article, as enacted by this Act.
206+ 4. Notify the patient of the need to attend any upcoming 10
207+appointments the patient has scheduled with the prescriber. 11
225208
226- SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
227-October 1, 2022.
209+ (3) The regulations shall waive the requirement to complete a training 12
210+program for a pharmacist who already has undergone the training as part of the 13
211+pharmacist’s formal educational program. 14
228212
229-Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.
213+Article – Insurance 15
214+
215+15–716. 16
216+
217+ (a) This section applies to individual, group, or blanket health insurance policies 17
218+and contracts delivered or issued for delivery in the State by insurers, nonprofit health 18
219+service plans, and health maintenance organizations that provide coverage for patient 19
220+assessment regarding, and administration of, self–administered medications [and], 20
221+maintenance injectable medications, AND INJECTABLE MEDIC ATIONS FOR TREATMENT 21
222+OF SEXUALLY TRANSMIT TED INFECTIONS . 22
223+
224+ (b) An entity subject to this section shall provide coverage for services rendered 23
225+by a licensed pharmacist under § 12–509 of the Health Occupations Article to an individual 24
226+who is covered under a policy or contract issued or delivered by the entity, to the same 25
227+extent as services rendered by any other licensed health care practitioner, for patient 26
228+assessment regarding and in administering self –administered medications [or], 27
229+maintenance injectable medications, OR INJECTABLE MEDICA TIONS FOR TREATMENT 28
230+OF SEXUALLY TRANSMIT TED INFECTIONS . 29
231+
232+ SECTION 2. AND BE IT FURTHER ENACTED, That, to the extent determined 30
233+appropriate by the State Board of Pharmacy, the regulations adopted by the State Board of 31
234+Pharmacy, in consultation with the State Board of Physicians and the State Board of 32
235+Nursing, under § 12–509 of the Health Occupations Article, as enacted by Chapters 757 33
236+and 758 of the Acts of 2021, for the administration of maintenance injectable medications 34
237+by a pharmacist shall be the same regulations for the administration of injectable 35 6 HOUSE BILL 229
238+
239+
240+medications for treatment of sexually transmitted infections by a pharmacist adopted in 1
241+accordance with § 12–509 of the Health Occupations Article, as enacted by this Act. 2
242+
243+ SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 3
244+October 1, 2022. 4
245+
246+
247+
248+
249+Approved:
250+________________________________________________________________________________
251+ Governor.
252+________________________________________________________________________________
253+ Speaker of the House of Delegates.
254+________________________________________________________________________________
255+ President of the Senate.