EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING LAW.
[Brackets] indicate matter deleted from existing law.
Underlining indicates amendments to bill.
Strike out indicates matter stricken from the bill by amendment or deleted from the law by
amendment.
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SENATE BILL 678
J5, J4, J1 3lr1760
CF HB 1151
By: Senator Beidle
Introduced and read first time: February 6, 2023
Assigned to: Finance
Committee Report: Favorable with amendments
Senate action: Adopted
Read second time: March 3, 2023
CHAPTER ______
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 2 SENATE BILL 678
Annotated Code of Maryland 1
(2017 Replacement Volume and 2022 Supplement) 2
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
That the Laws of Maryland read as follows: 4
Article – Health – General 5
15–148. 6
(a) Except for a drug or device for which the U.S. Food and Drug Administration 7
has issued a black box warning, the Program and the Maryland Children’s Health Program 8
may not apply a prior authorization requirement for a contraceptive drug or device that is: 9
(1) (i) An intrauterine device; or 10
(ii) An implantable rod; 11
(2) Approved by the U.S. Food and Drug Administration; and 12
(3) Obtained under a prescription written by an authorized prescriber. 13
(b) The Program and the Maryland Children’s Health Program shall provide 14
coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for 15
a 12–month period. 16
[(c) The Program and the Maryland Children’s Health Program shall provide 17
coverage for services, to the same extent as services rendered by any other licensed health 18
care practitioner, rendered to an enrollee by a licensed pharmacist under: 19
(1) § 12–509 of the Health Occupations Article in administering 20
self–administered medications, maintenance injectable medications, or injectable 21
medications for treatment of sexually transmitted infections; or 22
(2) § 12–511 of the Health Occupations Article in screening an enrollee and 23
prescribing contraceptives for the enrollee.] 24
15–151. 25
(A) THE PROGRAM AND THE MARYLAND CHILDREN’S HEALTH PROGRAM 26
SHALL PROVIDE COVERA GE FOR SERVICES REND ERED TO AN ENROLLEE BY A 27
LICENSED PHARMACIST ACTING WITHIN THE PH ARMACIST’S LAWFUL SCOPE OF 28
PRACTICE TO THE SAME EXTENT AS SERVIC ES RENDERED BY ANY O THER LICENSED 29
HEALTH CARE PROVIDER . 30
SENATE BILL 678 3
(B) REIMBURSEMENT FOR SER VICES PROVIDED UNDER SUBSECTION (A) OF 1
THIS SECTION MAY NOT BE CONDITIONED ON WH ETHER THE LICENSED P HARMACIST 2
IS: 3
(1) EMPLOYED BY A PHYSICI AN, PHARMACY, OR FACILITY; OR 4
(2) ACTING UNDER A PHYSIC IAN’S ORDERS. 5
Article – Insurance 6
15–716. 7
(a) This section applies to individual, group, or blanket health insurance policies 8
and contracts delivered or issued for delivery in the State by insurers, nonprofit health 9
service plans, and health maintenance organizations [that provide coverage for patient 10
assessment regarding, and administration of, self–administered medications, maintenance 11
injectable medications, and injectable medications for treatment of sexually transmitted 12
infections] THAT PROVIDE COVERAG E FOR SERVICES THAT ARE WITHIN THE LAWFU L 13
SCOPE OF PRACTICE OF A L ICENSED PHARMACIST . 14
(b) An entity subject to this section shall provide coverage for services rendered 15
by a licensed pharmacist [under § 12–509 of the Health Occupations Article] ACTING 16
WITHIN THE PHARMACIS T’S LAWFUL SCOPE OF PR ACTICE to an individual who is 17
covered under a policy or contract issued or delivered by the entity, to the same extent as 18
services rendered by any other licensed health care practitioner[, for patient assessment 19
regarding and in administering self–administered medications, maintenance injectable 20
medications, or injectable medications for treatment of sexually transmitted infections]. 21
(C) REIMBURSEMENT FOR SER VICES PROVIDED UNDER THIS SECTION MAY 22
NOT BE CONDITIONED O N WHETHER THE LICENS ED PHARMACIST IS : 23
(1) EMPLOYED BY A PHYSIC IAN, PHARMACY, OR FACILITY; OR 24
(2) ACTING UNDER A PHYSI CIAN’S ORDERS. 25
SECTION 2. AND BE IT FURTHER ENACTED, That, to implement § 15 –151 of the 26
Health – General Article, as enacted by Section 1 of this Act, on or before January 1, 2024, 27
the Maryland Department of Health shall apply for and obtain from the U.S. Department 28
of Health and Human Services any necessary amendments to or waivers for the Maryland 29
Medical Assistance Program or the Maryland Children’s Health Program. 30
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all 31
policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 32
after January 1, 2024. 33
4 SENATE BILL 678
SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall tak e effect 1
October 1, 2023. 2
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
President of the Senate.
________________________________________________________________________________
Speaker of the House of Delegates.