WES MOORE, Governor Ch. 300
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Chapter 300
(Senate Bill 678)
AN ACT concerning
Health Insurance – Reimbursement for Services Rendered by a Pharmacist
FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland
Children’s Health Program, and certain insurers, nonprofit health service plans, and
health maintenance organizations to provide coverage for all services rendered by a
licensed pharmacist within the pharmacist’s lawful scope of practice, rather than
only certain services, to the same extent as services rendered by any other health
care practitioner; and generally relating to reimbursement for health care services
provided by a pharmacist.
BY repealing and reenacting, with amendments,
Article – Health – General
Section 15–148
Annotated Code of Maryland
(2019 Replacement Volume and 2022 Supplement)
BY adding to
Article – Health – General
Section 15–151
Annotated Code of Maryland
(2019 Replacement Volume and 2022 Supplement)
BY repealing and reenacting, with amendments,
Article – Insurance
Section 15–716
Annotated Code of Maryland
(2017 Replacement Volume and 2022 Supplement)
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
That the Laws of Maryland read as follows:
Article – Health – General
15–148.
(a) Except for a drug or device for which the U.S. Food and Drug Administration
has issued a black box warning, the Program and the Maryland Children’s Health Program
may not apply a prior authorization requirement for a contraceptive drug or device that is:
(1) (i) An intrauterine device; or
Ch. 300 2023 LAWS OF MARYLAND
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(ii) An implantable rod;
(2) Approved by the U.S. Food and Drug Administration; and
(3) Obtained under a prescription written by an authorized prescriber.
(b) The Program and the Maryland Children’s Health Program shall provide
coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for
a 12–month period.
[(c) The Program and the Maryland Children’s Health Program shall provide
coverage for services, to the same extent as services rendered by any other licensed health
care practitioner, rendered to an enrollee by a licensed pharmacist under:
(1) § 12–509 of the Health Occupations Article in administering
self–administered medications, maintenance injectable medications, or injectable
medications for treatment of sexually transmitted infections; or
(2) § 12–511 of the Health Occupations Article in screening an enrollee and
prescribing contraceptives for the enrollee.]
15–151.
(A) THE PROGRAM AND THE MARYLAND CHILDREN’S HEALTH PROGRAM
SHALL PROVIDE COVERA GE FOR SERVICES REND ERED TO AN ENROLLEE BY A
LICENSED PHARMACIST ACTING WITHIN THE PH ARMACIST’S LAWFUL SCOPE OF
PRACTICE TO THE SAME EXTENT AS SERVICE S RENDERED BY ANY OT HER LICENSED
HEALTH CARE PROVIDER .
(B) REIMBURSEMENT FOR SER VICES PROVIDED UNDER SUBSECTION (A) OF
THIS SECTION MAY NOT BE CONDITIONED ON WH ETHER THE LICENSED P HARMACIST
IS:
(1) EMPLOYED BY A PHYSICI AN, PHARMACY, OR FACILITY; OR
(2) ACTING UNDER A PHYSIC IAN’S ORDERS.
Article – Insurance
15–716.
(a) This section applies to individual, group, or blanket health insurance policies
and contracts delivered or issued for delivery in the State by insurers, nonprofit health
service plans, and health maintenance organizations [that provide coverage for patient
assessment regarding, and administration of, self–administered medications, maintenance WES MOORE, Governor Ch. 300
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injectable medications, and injectable medications for treatment of sexually transmitted
infections] THAT PROVIDE COVERAG E FOR SERVICES THAT ARE WITHIN THE LAWFU L
SCOPE OF PRACTICE OF A L ICENSED PHARMACIST .
(b) An entity subject to this section shall provide coverage for services rendered
by a licensed pharmacist [under § 12–509 of the Health Occupations Article] ACTING
WITHIN THE PHARMACIS T’S LAWFUL SCOPE OF PR ACTICE to an individual who is
covered under a policy or contract issued or delivered by the entity, to the same extent as
services rendered by any other licensed health care practitioner[, for patient assessment
regarding and in administering self–administered medications, maintenance injectable
medications, or injectable medications for treatment of sexually transmitted infections].
(C) REIMBURSEMENT FOR SER VICES PROVIDED UNDER THIS SECTION MAY
NOT BE CONDITIONED O N WHETHER THE LICENS ED PHARMACIST IS :
(1) EMPLOYED BY A PHYSIC IAN, PHARMACY, OR FACILITY; OR
(2) ACTING UNDER A PHYSI CIAN’S ORDERS.
SECTION 2. AND BE IT FURTHER ENACTED, That, to implement § 15 –151 of the
Health – General Article, as enacted by Section 1 of this Act, on or before January 1, 2024,
the Maryland Department of Health shall apply for and obtain from the U.S. Department
of Health and Human Services any necessary amendments to or waivers for the Maryland
Medical Assistance Program or the Maryland Children’s Health Program.
SECTION 3. 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, 2024.
SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall tak e effect
October 1, 2023.
Approved by the Governor, May 3, 2023.