LAWRENCE J. HOGAN, JR., Governor Ch. 684
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Chapter 684
(House Bill 970)
AN ACT concerning
Managed Care Organizations and Health Insurance Carriers – Prior
Authorization for HIV Postexposure Prophylaxis for Victims of Sexual Offenses
– Prohibition
FOR the purpose of prohibiting managed care organizations and certain insurers, nonprofit
health service plans, and health maintenance organizations from applying a prior
authorization requirement for prescription drugs used as postexposure prophylaxis
for the prevention of HIV if the drug is prescribed to a victim of an alleged rape or
sexual offense for use in accordance with Centers for Disease Control and Prevention
guidelines; and generally relating to prescription drugs used as postexposure
prophylaxis for the prevention of HIV infection and prior authorizations.
BY repealing and reenacting, without amendments,
Article – Health – General
Section 15–103(a)(1)
Annotated Code of Maryland
(2019 Replacement Volume and 2021 Supplement)
BY adding to
Article – Health – General
Section 15–103(b)(31)
Annotated Code of Maryland
(2019 Replacement Volume and 2021 Supplement)
BY adding to
Article – Insurance
Section 15–857
Annotated Code of Maryland
(2017 Replacement Volume and 2021 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
15–103.
(a) (1) The Secretary shall administer the Maryland Medical Assistance
Program.
Ch. 684 2022 LAWS OF MARYLAND
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(b) (31) A MANAGED CARE ORGANIZ ATION MAY NOT APPLY A PRIOR
AUTHORIZATION REQUIR EMENT FOR A PRESCRIP TION DRUG USED AS
POSTEXPOSURE PROPHYL AXIS FOR THE PREVENT ION OF HIV IF THE
PRESCRIPTION DRUG IS PRESCRIBED TO A VICTIM OF AN AL LEGED RAPE OR SEXUAL
OFFENSE FOR USE IN ACCORDANC E WITH CENTERS FOR DISEASE CONTROL AND
PREVENTION GUIDELINES .
Article – Insurance
15–857.
(A) (1) THIS SECTION APPLIES TO:
(I) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT
PROVIDE COVERAGE FOR PRESCRIPTION DRUGS U NDER INDIVIDUAL, GROUP, OR
BLANKET HEALTH INSUR ANCE POLICIES OR CON TRACTS THAT ARE ISSU ED OR
DELIVERED IN THE STATE; AND
(II) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE
COVERAGE FOR PRESCRI PTION DRUGS UNDER IN DIVIDUAL OR GROUP CO NTRACTS
THAT ARE ISSUED OR DELIVERED IN THE STATE.
(2) AN INSURER, A NONPROFIT HEALTH S ERVICE PLAN, OR A HEALTH
MAINTENANCE ORGANIZA TION THAT PROVIDES C OVERAGE FOR PRESCRIP TION
DRUGS THROUGH A PHAR MACY BENEFITS MANAGE R IS SUBJECT TO THE
REQUIREMENTS OF THIS SECTION.
(B) AN ENTITY SUBJECT TO TH IS SECTION MAY NOT A PPLY A PRIOR
AUTHORIZATION REQUIR EMENT FOR A PRESCRIP TION DRUG USED AS
POSTEXPOSURE PROPHYL AXIS FOR THE PREVENT ION OF HIV IF THE
PRESCRIPTION DRUG IS PRESCRIBED TO A VICTIM OF AN AL LEGED RAPE OR SEXUAL
OFFENSE FOR USE IN ACCORDANCE WITH CENTERS FOR DISEASE CONTROL AND
PREVENTION GUIDELINES .
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or
after January 1, 2023.
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
January 1, 2023.
Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.