EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTIN G LAW.
[Brackets] indicate matter deleted from existing law.
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SENATE BILL 678
J5, J4, J1 3lr1760
CF 3lr1759
By: Senator Beidle
Introduced and read first time: February 6, 2023
Assigned to: Finance
A BILL ENTITLED
AN ACT concerning 1
Health Insurance – Reimbursement for Services Rendered by a Pharmacist 2
FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland 3
Children’s Health Program, and certain insurers, nonprofit health service plans, and 4
health maintenance organizations to provide coverage for all services rendered by a 5
licensed pharmacist within the pharmacist’s lawful scope of practice, rather than 6
only certain services, to the same extent as services rendered by any other health 7
care practitioner; and generally relating to reimbursement for health care services 8
provided by a pharmacist. 9
BY repealing and reenacting, with amendments, 10
Article – Health – General 11
Section 15–148 12
Annotated Code of Maryland 13
(2019 Replacement Volume and 2022 Supplement) 14
BY adding to 15
Article – Health – General 16
Section 15–151 17
Annotated Code of Maryland 18
(2019 Replacement Volume and 2022 Supplement) 19
BY repealing and reenacting, with amendments, 20
Article – Insurance 21
Section 15–716 22
Annotated Code of Maryland 23
(2017 Replacement Volume and 2022 Supplement) 24
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 25
That the Laws of Maryland read as follows: 26
2 SENATE BILL 678
Article – Health – General 1
15–148. 2
(a) Except for a drug or device for which the U.S. Food and Drug Administration 3
has issued a black box warning, the Program and the Maryland Children’s Health Program 4
may not apply a prior authorization requirement for a contraceptive drug or device that is: 5
(1) (i) An intrauterine device; or 6
(ii) An implantable rod; 7
(2) Approved by the U.S. Food and Drug Administration; and 8
(3) Obtained under a prescription written by an authorized prescriber. 9
(b) The Program and the Maryland Children’s Health Program shall provide 10
coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for 11
a 12–month period. 12
[(c) The Program and the Maryland Children’s Health Program shall provide 13
coverage for services, to the same extent as services rendered by any other licensed health 14
care practitioner, rendered to an enrollee by a licensed pharmacist under: 15
(1) § 12–509 of the Health Occupations Article in administering 16
self–administered medications, maintenance injectable medications, or injectable 17
medications for treatment of sexually transmitted infections; or 18
(2) § 12–511 of the Health Occupations Article in screening an enrollee and 19
prescribing contraceptives for the enrollee.] 20
15–151. 21
(A) THE PROGRAM AND THE MARYLAND CHILDREN’S HEALTH PROGRAM 22
SHALL PROVIDE COVERA GE FOR SE RVICES RENDERED TO A N ENROLLEE BY A 23
LICENSED PHARMACIST ACTING WITHIN THE PH ARMACIST’S LAWFUL SCOPE OF 24
PRACTICE TO THE SAME EXTENT AS SERVICES R ENDERED BY ANY OTHER LICENSED 25
HEALTH CARE PROVIDER . 26
(B) REIMBURSEMENT FOR SER VICES PROVIDED UNDER SUBSECTION (A) OF 27
THIS SECTION MAY NOT BE CONDITIONED ON WH ETHER THE LICENSED P HARMACIST 28
IS: 29
(1) EMPLOYED BY A PHYSICI AN, PHARMACY, OR FACILITY; OR 30
(2) ACTING UNDER A PHYSIC IAN’S ORDERS. 31 SENATE BILL 678 3
Article – Insurance 1
15–716. 2
(a) This section applies to individual, group, or blanket health insurance policies 3
and contracts delivered or issued for delivery in the State by insurers, nonprofit health 4
service plans, and health maintenance organizations [that provide coverage for patient 5
assessment regarding, and administration of, self–administered medications, maintenance 6
injectable medications, and injectable medications for treatment of sexually transmitted 7
infections]. 8
(b) An entity subject to this section shall provide coverage for services rendered 9
by a licensed pharmacist [under § 12–509 of the Health Occupations Article] ACTING 10
WITHIN THE PHARMACIS T’S LAWFUL SCOPE OF PR ACTICE to an individual who is 11
covered under a policy or contract issued or delivered by the entity, to the same extent as 12
services rendered by any other licensed health care practitioner[, for patient assessment 13
regarding and in administering self–administered medications, maintenance injectable 14
medications, or injectable medications for treatment of sexually transmitted infections]. 15
(C) REIMBURSEMENT FOR SER VICES PROVIDED UNDER THIS SECTION MAY 16
NOT BE CONDITIONED O N WHETHER THE LICENS ED PHARMACIST IS : 17
(1) EMPLOYED BY A PHYSIC IAN, PHARMACY, OR FACILITY; OR 18
(2) ACTING UNDER A PHYSI CIAN’S ORDERS. 19
SECTION 2. AND BE IT FURTHER ENACTED, That, to implement § 15 –151 of the 20
Health – General Article, as enacted by Section 1 of this Act, on or before January 1, 2024, 21
the Maryland Department of Health shall apply for and obtain from the U.S. Department 22
of Health and Human Services any necessary amendments to or waivers for the Maryland 23
Medical Assistance Program or the Maryland Children’s Health Program. 24
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 25
October 1, 2023. 26