EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
*hb0970*
HOUSE BILL 970
J5 2lr2306
CF SB 787
By: Delegate Kelly
Introduced and read first time: February 10, 2022
Assigned to: Health and Government Operations
A BILL ENTITLED
AN ACT concerning 1
Managed Care Organizations and Health Insurance Carriers – Prior 2
Authorization for HIV Postexposure Prophylaxis for Victims of Sexual Offenses 3
– Prohibition 4
FOR the purpose of prohibiting managed care organizations and certain insurers, nonprofit 5
health service plans, and health maintenance organizations from applying a prior 6
authorization requirement for prescription drugs used as postexposure prophylaxis 7
for the prevention of HIV if the drug is prescribed to a victim of an alleged rape or 8
sexual offense; and generally relating to prescription drugs used as postexposure 9
prophylaxis for the prevention of HIV infection and prior authorizations. 10
BY repealing and reenacting, without amendments, 11
Article – Health – General 12
Section 15–103(a)(1) 13
Annotated Code of Maryland 14
(2019 Replacement Volume and 2021 Supplement) 15
BY adding to 16
Article – Health – General 17
Section 15–103(b)(31) 18
Annotated Code of Maryland 19
(2019 Replacement Volume and 2021 Supplement) 20
BY adding to 21
Article – Insurance 22
Section 15–857 23
Annotated Code of Maryland 24
(2017 Replacement Volume and 2021 Supplement) 25
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
That the Laws of Maryland read as follows: 27 2 HOUSE BILL 970
Article – Health – General 1
15–103. 2
(a) (1) The Secretary shall administer the Maryland Medical Assistance 3
Program. 4
(b) (31) A MANAGED CARE ORGANIZ ATION MAY NOT APPLY A PRIOR 5
AUTHORIZATION REQUIR EMENT FOR A PRESCRIP TION DRUG USED AS 6
POSTEXPOSURE PROPHYL AXIS FOR THE PREVENT ION OF HIV IF THE 7
PRESCRIPTION DRUG IS PRESCRIBED TO A VICT IM OF AN ALLEGED RAP E OR SEXUAL 8
OFFENSE. 9
Article – Insurance 10
15–857. 11
(A) (1) THIS SECTION APPLIES TO: 12
(I) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 13
PROVIDE COVERAGE FOR PRESCRIPTION DRUGS U NDER INDIVIDUAL , GROUP, OR 14
BLANKET HEALTH INSUR ANCE POLICIES OR CON TRACTS THAT ARE ISSU ED OR 15
DELIVERED IN THE STATE; AND 16
(II) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 17
COVERAGE FOR PRESCRI PTION DRUGS U NDER INDIVIDUAL OR G ROUP CONTRACTS 18
THAT ARE ISSUED OR D ELIVERED IN THE STATE. 19
(2) AN INSURER, A NONPROFIT HEALTH S ERVICE PLAN, OR A HEALTH 20
MAINTENANCE ORGANIZA TION THAT PROVIDES C OVERAGE FOR PRESCRIP TION 21
DRUGS THROUGH A PHAR MACY BENEFITS MANAGE R IS SUBJ ECT TO THE 22
REQUIREMENTS OF THIS SECTION. 23
(B) AN ENTITY SUBJECT TO THIS SECTION MAY NOT APPLY A PRIOR 24
AUTHORIZATION REQUIR EMENT FOR A PRESCRIP TION DRUG USED AS 25
POSTEXPOSURE PROPHYL AXIS FOR THE PREVENTION O F HIV IF THE 26
PRESCRIPTION DRUG IS PRESCRIBED TO A VICTIM OF AN ALLEGED RAPE OR SEXUAL 27
OFFENSE. 28
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 29
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 30
after January 1, 2023. 31
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 32 HOUSE BILL 970 3
January 1, 2023. 1