MD
Maryland Senate Bill SB19

Maryland 2022 Regular Session

Maryland Senate Bill SB19 Compare Versions

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1- LAWRENCE J. HOGAN, JR., Governor Ch. 720
21
3-– 1 –
4-Chapter 720
5-(Senate Bill 19)
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+ Italics indicate opposite chamber/conference committee amendments.
9+ *sb0019*
810
9-Pharmacists – Administration of Maintenance Injectable Medications –
10-Medications for Treatment of Sexually Transmitted Infections
11+SENATE BILL 19
12+J2, J1 (2lr1028)
13+ENROLLED BILL
14+— Education, Health, and Environmental Affairs/Health and Government
15+Operations —
16+Introduced by Senator Lam
1117
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.
18+Read and Examined by Proofreaders:
2319
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)
20+_______________________________________________
21+Proofreader.
22+_______________________________________________
23+Proofreader.
2924
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)
25+Sealed with the Great Seal and presented to the Governor, for his approval this
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+_______ day of _______________ at ________________________ o’clock, ________M.
4128
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)
29+______________________________________________
30+President.
4731
48-BY repealing and reenacting, with amendments,
49- Article – Insurance Ch. 720 2022 LAWS OF MARYLAND
32+CHAPTER ______
5033
51-– 2 –
52- Section 15–716
53- Annotated Code of Maryland
54- (2017 Replacement Volume and 2021 Supplement)
34+AN ACT concerning 1
5535
56- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
57-That the Laws of Maryland read as follows:
36+Pharmacists – Administration of Maintenance Injectable Medications – 2
37+Medications for Treatment of Sexually Transmitted Infections 3
5838
59-Article – Health – General
39+FOR the purpose of altering the definition of “maintenance injectable medication” for the 4
40+purposes of provisions of law governing the administration of maintenance injectable 5
41+medications by pharmacists to include a medication that treats a sexually 6
42+transmitted infection and is not a vaccine defining “injectable medications for 7
43+treatment of sexually transmitted infections” for the purposes of authorizing 8
44+pharmacists to administer the medications; requiring certain insurers, nonprofit 9
45+health service plans, health maintenance organizations, the Maryland Medical 10
46+Assistance Program, and the Maryland Children’s Health Program to provide certain 11
47+coverage for the administration of the medication by a pharmacist; and generally 12
48+relating to the administration of maintenance injectable medications by 13
49+pharmacists. 14 2 SENATE BILL 19
6050
61-15–148.
6251
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:
6652
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 TR ANSMITTED INFECTIONS ; or
53+BY repealing and reenacting, with amendments, 1
54+ Article – Health Occupations 2
55+Section 12–101(o–1) 3
56+ Annotated Code of Maryland 4
57+ (2021 Replacement Volume) 5
7058
71- (2) § 12–511 of the Health Occupations Article in screening an enrollee and
72-prescribing contraceptives for the enrollee.
59+BY repealing and reenacting, with amendments, 6
60+ Article – Health – General 7
61+ Section 15–148(c) 8
62+ Annotated Code of Maryland 9
63+ (2019 Replacement Volume and 2021 Supplement) 10
7364
74-Article – Health Occupations
65+BY adding to 11
66+ Article – Health Occupations 12
67+ Section 12–101(l–1) 13
68+ Annotated Code of Maryland 14
69+ (2021 Replacement Volume) 15
7570
76-12–101.
71+BY repealing and reenacting, without with amendments, 16
72+ Article – Health Occupations 17
73+Section 12–509(a) and (b) 12–509 18
74+ Annotated Code of Maryland 19
75+ (2021 Replacement Volume) 20
7776
78- (o–1) (1) “Maintenance injectable medication” means a medication that:
77+BY repealing and reenacting, with amendments, 21
78+ Article – Insurance 22
79+ Section 15–716 23
80+ Annotated Code of Maryland 24
81+ (2017 Replacement Volume and 2021 Supplement) 25
7982
80- (i) Is administered by injection other than intravenously; and
83+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 26
84+That the Laws of Maryland read as follows: 27
8185
82- (ii) 1. Treats a chronic need, condition, or disorder; OR
86+Article – Health – General 28
8387
84- 2. TREATS A SEXUALLY TRA NSMITTED INFECTION A ND
85-IS NOT A VACCINE .
88+15–148. 29
8689
87- (2) “Maintenance injectable medication” includes a medication for the
88-treatment of a psychiatric disorder or substance use disorder, contraception, and vitamins.
90+ (c) The Program and the Maryland Children’s Health Program shall provide 30
91+coverage for services, to the same extent as services rendered by any other licensed health 31
92+care practitioner, rendered to an enrollee by a licensed pharmacist under: 32
8993
90- (L–1) “INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY
91-TRANSMITTED INFECTIO N” MEANS A MEDICATION T HAT:
94+ (1) § 12–509 of the Health Occupations Article in administering 33
95+self–administered medications [or], maintenance injectable medications, OR INJECTABLE 34
96+MEDICATIONS FOR TREA TMENT OF SEXUALLY TR ANSMITTED INFECTIONS ; or 35
97+ SENATE BILL 19 3
9298
93- (1) IS ADMINISTERED BY IN JECTION OTHER THAN I NTRAVENOUSLY ;
9499
95- (2) TREATS A SEXUALLY TRANSMITTED INFECTIO N; AND
96- LAWRENCE J. HOGAN, JR., Governor Ch. 720
100+ (2) § 12–511 of the Health Occupations Article in screening an enrollee and 1
101+prescribing contraceptives for the enrollee. 2
97102
98-– 3 –
99- (3) IS NOT A VACCINE.
103+Article – Health Occupations 3
100104
101-12–509.
105+12–101. 4
102106
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:
107+ (o–1) (1) “Maintenance injectable medication” means a medication that: 5
106108
107- (1) A self–administered drug to a patient that is prescribed by an
108-authorized prescriber; and
109+ (i) Is administered by injection other than intravenously; and 6
109110
110- (2) Subject to subsection (b) of this section, a maintenance injectable
111-medication OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY
112-TRANSMITTED INFECTIO N that is not a biological product to a patient:
111+ (ii) 1. Treats a chronic need, condition, or disorder; OR 7
113112
114- (i) That is prescribed by an authorized prescriber;
113+ 2. TREATS A SEXUALLY TRA NSMITTED INFECTION A ND 8
114+IS NOT A VACCINE. 9
115115
116- (ii) In accordance with a standing order issued by an authorized
117-public health official; or
116+ (2) “Maintenance injectable medication” includes a medication for the 10
117+treatment of a psychiatric disorder or substance use disorder, contraception, and vitamins. 11
118118
119- (iii) In accordance with a protocol under Subtitle 6A of this title.
119+ (L–1) “INJECTABLE MEDICATION FOR TREATMENT OF A S EXUALLY 12
120+TRANSMITTED INFECTIO N” MEANS A MEDICATION T HAT: 13
120121
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 INFECTIO N under subsection (a)(2) of this section unless the pharmacist
124-receives written approval from the prescriber.
122+ (1) IS ADMINISTERED BY IN JECTION OTHER THAN I NTRAVENOUSLY ; 14
125123
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:
124+ (2) TREATS A SEXUALLY TRANSMITTED INFECTIO N; AND 15
129125
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 ;
126+ (3) IS NOT A VACCINE. 16
133127
134- (ii) That a pharmacist must use to administer [a]:
128+12–509. 17
135129
136- 1. A maintenance injectable medication after an initial dose
137-is administered by the prescriber; OR
130+ (a) In addition to the authority granted to a pharmacist under § 12–508 of this 18
131+subtitle, a pharmacist, in accordance with regulations adopted by the Board, may 19
132+administer: 20
138133
139- 2. AN INJECTABLE MEDICAT ION FOR TREATMENT OF A
140-SEXUALLY TRANSMITTED INFECTION;
134+ (1) A self–administered drug to a patient that is prescribed by an 21
135+authorized prescriber; and 22
141136
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. 720 2022 LAWS OF MARYLAND
137+ (2) Subject to subsection (b) of this section, a maintenance injectable 23
138+medication OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY 24
139+TRANSMITTED INFECTIO N that is not a biological product to a patient: 25
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+ (i) That is prescribed by an authorized prescriber; 26
148142
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.
143+ (ii) In accordance with a standing order issued by an authorized 27
144+public health official; or 28
145+ 4 SENATE BILL 19
151146
152- (2) The regulations shall require a pharmacist to:
153147
154- (i) Except as provided in paragraph (3) of this subsection, complete
155-a training program approved by the Board for:
148+ (iii) In accordance with a protocol under Subtitle 6A of this title. 1
156149
157- 1. Administering maintenance injectable medications AND
158-INJECTABLE MEDICATIO NS FOR TREATMENT OF A SEXUALLY TRANSMITT ED
159-INFECTION; and
150+ (b) A pharmacist may not administer an initial dose of a maintenance injectable 2
151+medication product OR AN INJECTABLE MED ICATION FOR TREATMEN T OF A SEXUALLY 3
152+TRANSMITTED INFECTIO N under subsection (a)(2) of this section unless the pharmacist 4
153+receives written approval from the prescriber. 5
160154
161- 2. Managing the populations the pharmacist serves, the
162-medications being administered, and the current guidelines relating to these populations
163-and medications;
155+ (c) (1) On or before September 1, 2021, the Board, in consultation with the 6
156+State Board of Physicians and the State Board of Nursing, shall adopt regulations 7
157+establishing standard procedures: 8
164158
165- (ii) Follow the standard procedures established by the Board; and
159+ (i) For notifying a patient about payment for services before the 9
160+pharmacist administers a maintenance injectable medication OR AN INJECTABLE 10
161+MEDICATION FOR TREAT MENT OF A SEXUALLY T RANSMITTED INFECTION ; 11
166162
167- (iii) After administering a maintenance injectable medication OR AN
168-INJECTABLE MEDICATIO N FOR TREA TMENT OF A SEXUALLY TRANSMITTED
169-INFECTION:
163+ (ii) That a pharmacist must use to administer [a]: 12
170164
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;
165+ 1. A maintenance injectable medication after an initial dose 13
166+is administered by the prescriber; OR 14
175167
176- 2. Provide the patient with a written record of the
177-maintenance injectable medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A
178-SEXUALLY TRANSMITTED INFECTION administered;
168+ 2. AN INJECTABLE MEDICAT ION FOR TREATMENT OF A 15
169+SEXUALLY TRANSMITTED INFECTION; 16
179170
180- 3. Record in any electronic or written health record on the
181-patient maintained by the pharmacist:
171+ (iii) That a pharmacist must use to administer an initial dose of a 17
172+maintenance injectable medication OR AN INJECTABLE MED ICATION FOR TREATMEN T 18
173+OF A SEXUALLY TRANSM ITTED INFECTION if the administration of the initial dose is 19
174+authorized under subsection (b) of this section; and 20
182175
183- A. The administering of the maintenance injectable
184-medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY
185-TRANSMITTED INFECTIO N; and
176+ (iv) For communicating to the prescriber whether a medication was 21
177+administered to a specific patient and relevant information about the patient’s condition. 22
186178
187- B. Any pertinent details about the patient’s condition; and
179+ (2) The regulations shall require a pharmacist to: 23
188180
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. 720
181+ (i) Except as provided in paragraph (3) of this subsection, complete 24
182+a training program approved by the Board for: 25
191183
192-– 5 –
184+ 1. Administering maintenance injectable medications AND 26
185+INJECTABLE MEDICATIO NS FOR TREATMENT OF A SEXUALLY TRANSMITT ED 27
186+INFECTION; and 28
193187
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.
188+ 2. Managing the populations the pharmacist serves, the 29
189+medications being administered, and the current guidelines relating to these populations 30
190+and medications; 31
197191
198-Article – Insurance
192+ (ii) Follow the standard procedures established by the Board; and 32
193+ SENATE BILL 19 5
199194
200-15–716.
201195
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 .
196+ (iii) After administering a maintenance injectable medication OR AN 1
197+INJECTABLE MEDICATIO N FOR TREATMENT OF A SEXUALLY TRANSMITTED 2
198+INFECTION: 3
208199
209- (b) An entity subject to this section shall provide coverage for services rendered by
210-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 extent
212-as services rendered by any other licensed health care practitioner, for patient assessment
213-regarding and in administering self–administered medications [or], maintenance injectable
214-medications, OR INJECTABLE MEDICA TIONS FOR TREATMENT OF SEXUALLY
215-TRANSMITTED INFECTIO NS.
200+ 1. Notify the prescriber that the maintenance injectable 4
201+medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY 5
202+TRANSMITTED INFECTIO N was administered and of any relevant details about the 6
203+patient’s condition; 7
216204
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 and
221-758 of the Acts of the General Assembly of 2021, for the administration of maintenance
222-injectable medications by a pharmacist shall be the same regulations for the administration
223-of injectable medications for treatment of sexually transmitted infections by a pharmacist
224-adopted in accordance with § 12–509 of the Health Occupations Article, as enacted by this
225-Act.
205+ 2. Provide the patient with a written record of the 8
206+maintenance injectable medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A 9
207+SEXUALLY TRANSMITTED INFECTION administered; 10
226208
227- SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect
228-October 1, 2022.
209+ 3. Record in any electronic or written health record on the 11
210+patient maintained by the pharmacist: 12
229211
230-Enacted under Article II, § 17(c) of the Maryland Constitution, May 29, 2022.
212+ A. The administering of the maintenance injectable 13
213+medication OR INJECTABLE MEDICA TION FOR TREATMENT O F A SEXUALLY 14
214+TRANSMITTED INFECTIO N; and 15
215+
216+ B. Any pertinent details about the patient’s condition; and 16
217+
218+ 4. Notify the patient of the need to attend any upcoming 17
219+appointments the patient has scheduled with the prescriber. 18
220+
221+ (3) The regulations shall waive the requirement to complete a training 19
222+program for a pharmacist who already has undergone the training as part of the 20
223+pharmacist’s formal educational program. 21
224+
225+Article – Insurance 22
226+
227+15–716. 23
228+
229+ (a) This section applies to individual, group, or blanket health insurance policies 24
230+and contracts delivered or issued for delivery in the State by insurers, nonprofit health 25
231+service plans, and health maintenance organizations that provide coverage for patient 26
232+assessment regarding, and administration of, self–administered medications [and], 27
233+maintenance injectable medications, AND INJECTABLE MEDIC ATIONS FOR TREATMENT 28
234+OF SEXUALLY TRANSMIT TED INFECTIONS . 29
235+
236+ (b) An entity subject to this section shall provide coverage for services rendered by 30
237+a licensed pharmacist under § 12–509 of the Health Occupations Article to an individual 31
238+who is covered under a policy or contract issued or delivered by the entity, to the same extent 32
239+as services rendered by any other licensed health care practitioner, for patient assessment 33
240+regarding and in administering self–administered medications [or], maintenance injectable 34 6 SENATE BILL 19
241+
242+
243+medications, OR INJECTABLE MEDICA TIONS FOR TREATMENT OF SEXUALLY 1
244+TRANSMITTED INFECTIO NS. 2
245+
246+ SECTION 2. AND BE IT FURTHER ENACTED, That, to the extent determined 3
247+appropriate by the State Board of Pharmacy, the regulations adopted by the State Board of 4
248+Pharmacy, in consultation with the State Board of Physicians and the State Board of 5
249+Nursing, under § 12–509 of the Health Occupations Article, as enacted by Chapters 757 and 6
250+758 of the Acts of the General Assembly of 2021, for the administration of maintenance 7
251+injectable medications by a pharmacist shall be the same regulations for the administration 8
252+of injectable medications for treatment of sexually transmitted infections by a pharmacist 9
253+adopted in accordance with § 12–509 of the Health Occupations Article, as enacted by this 10
254+Act. 11
255+
256+ SECTION 2. 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 12
257+October 1, 2022. 13
258+
259+
260+
261+
262+Approved:
263+________________________________________________________________________________
264+ Governor.
265+________________________________________________________________________________
266+ President of the Senate.
267+________________________________________________________________________________
268+ Speaker of the House of Delegates.