MD
Maryland Senate Bill SB678

Maryland 2023 Regular Session

Maryland Senate Bill SB678 Compare Versions

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1- WES MOORE, Governor Ch. 300
21
3-– 1 –
4-Chapter 300
5-(Senate Bill 678)
62
7-AN ACT concerning
3+EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXIS TING 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+ *sb0678*
89
9-Health Insurance – Reimbursement for Services Rendered by a Pharmacist
10+SENATE BILL 678
11+J5, J4, J1 3lr1760
12+ CF HB 1151
13+By: Senator Beidle
14+Introduced and read first time: February 6, 2023
15+Assigned to: Finance
16+Committee Report: Favorable with amendments
17+Senate action: Adopted
18+Read second time: March 3, 2023
1019
11-FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland
12-Children’s Health Program, and certain insurers, nonprofit health service plans, and
13-health maintenance organizations to provide coverage for all services rendered by a
14-licensed pharmacist within the pharmacist’s lawful scope of practice, rather than
15-only certain services, to the same extent as services rendered by any other health
16-care practitioner; and generally relating to reimbursement for health care services
17-provided by a pharmacist.
20+CHAPTER ______
1821
19-BY repealing and reenacting, with amendments,
20- Article – Health – General
21-Section 15–148
22- Annotated Code of Maryland
23- (2019 Replacement Volume and 2022 Supplement)
22+AN ACT concerning 1
2423
25-BY adding to
26- Article – Health – General
27-Section 15–151
28- Annotated Code of Maryland
29- (2019 Replacement Volume and 2022 Supplement)
24+Health Insurance – Reimbursement for Services Rendered by a Pharmacist 2
3025
31-BY repealing and reenacting, with amendments,
32- Article – Insurance
33-Section 15–716
34- Annotated Code of Maryland
35- (2017 Replacement Volume and 2022 Supplement)
26+FOR the purpose of requiring the Maryland Medical Assistance Program, the Maryland 3
27+Children’s Health Program, and certain insurers, nonprofit health service plans, and 4
28+health maintenance organizations to provide coverage for all services rendered by a 5
29+licensed pharmacist within the pharmacist’s lawful scope of practice, rather than 6
30+only certain services, to the same extent as services rendered by any other health 7
31+care practitioner; and generally relating to reimbursement for health care services 8
32+provided by a pharmacist. 9
3633
37- SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,
38-That the Laws of Maryland read as follows:
34+BY repealing and reenacting, with amendments, 10
35+ Article – Health – General 11
36+Section 15–148 12
37+ Annotated Code of Maryland 13
38+ (2019 Replacement Volume and 2022 Supplement) 14
3939
40-Article – Health – General
40+BY adding to 15
41+ Article – Health – General 16
42+Section 15–151 17
43+ Annotated Code of Maryland 18
44+ (2019 Replacement Volume and 2022 Supplement) 19
4145
42-15–148.
46+BY repealing and reenacting, with amendments, 20
47+ Article – Insurance 21
48+Section 15–716 22 2 SENATE BILL 678
4349
44- (a) Except for a drug or device for which the U.S. Food and Drug Administration
45-has issued a black box warning, the Program and the Maryland Children’s Health Program
46-may not apply a prior authorization requirement for a contraceptive drug or device that is:
4750
48- (1) (i) An intrauterine device; or
49- Ch. 300 2023 LAWS OF MARYLAND
51+ Annotated Code of Maryland 1
52+ (2017 Replacement Volume and 2022 Supplement) 2
5053
51-– 2 –
52- (ii) An implantable rod;
54+ SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 3
55+That the Laws of Maryland read as follows: 4
5356
54- (2) Approved by the U.S. Food and Drug Administration; and
57+Article – Health – General 5
5558
56- (3) Obtained under a prescription written by an authorized prescriber.
59+15–148. 6
5760
58- (b) The Program and the Maryland Children’s Health Program shall provide
59-coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for
60-a 12–month period.
61+ (a) Except for a drug or device for which the U.S. Food and Drug Administration 7
62+has issued a black box warning, the Program and the Maryland Children’s Health Program 8
63+may not apply a prior authorization requirement for a contraceptive drug or device that is: 9
6164
62- [(c) The Program and the Maryland Children’s Health Program shall provide
63-coverage for services, to the same extent as services rendered by any other licensed health
64-care practitioner, rendered to an enrollee by a licensed pharmacist under:
65+ (1) (i) An intrauterine device; or 10
6566
66- (1) § 12–509 of the Health Occupations Article in administering
67-self–administered medications, maintenance injectable medications, or injectable
68-medications for treatment of sexually transmitted infections; or
67+ (ii) An implantable rod; 11
6968
70- (2) § 12–511 of the Health Occupations Article in screening an enrollee and
71-prescribing contraceptives for the enrollee.]
69+ (2) Approved by the U.S. Food and Drug Administration; and 12
7270
73-15–151.
71+ (3) Obtained under a prescription written by an authorized prescriber. 13
7472
75- (A) THE PROGRAM AND THE MARYLAND CHILDREN’S HEALTH PROGRAM
76-SHALL PROVIDE COVERA GE FOR SERVICES REND ERED TO AN ENROLLEE BY A
77-LICENSED PHARMACIST ACTING WITHIN THE PH ARMACIST’S LAWFUL SCOPE OF
78-PRACTICE TO THE SAME EXTENT AS SERVICE S RENDERED BY ANY OT HER LICENSED
79-HEALTH CARE PROVIDER .
73+ (b) The Program and the Maryland Children’s Health Program shall provide 14
74+coverage for a single dispensing to an enrollee of a supply of prescription contraceptives for 15
75+a 12–month period. 16
8076
81- (B) REIMBURSEMENT FOR SER VICES PROVIDED UNDER SUBSECTION (A) OF
82-THIS SECTION MAY NOT BE CONDITIONED ON WH ETHER THE LICENSED P HARMACIST
83-IS:
77+ [(c) The Program and the Maryland Children’s Health Program shall provide 17
78+coverage for services, to the same extent as services rendered by any other licensed health 18
79+care practitioner, rendered to an enrollee by a licensed pharmacist under: 19
8480
85- (1) EMPLOYED BY A PHYSICI AN, PHARMACY, OR FACILITY; OR
81+ (1) § 12–509 of the Health Occupations Article in administering 20
82+self–administered medications, maintenance injectable medications, or injectable 21
83+medications for treatment of sexually transmitted infections; or 22
8684
87- (2) ACTING UNDER A PHYSIC IAN’S ORDERS.
85+ (2) § 12–511 of the Health Occupations Article in screening an enrollee and 23
86+prescribing contraceptives for the enrollee.] 24
8887
89-Article – Insurance
88+15–151. 25
9089
91-15–716.
90+ (A) THE PROGRAM AND THE MARYLAND CHILDREN’S HEALTH PROGRAM 26
91+SHALL PROVIDE COVERA GE FOR SERVICES REND ERED TO AN ENROLLEE BY A 27
92+LICENSED PHARMACIST ACTING WITHIN THE PH ARMACIST’S LAWFUL SCOPE OF 28
93+PRACTICE TO THE SAME EXTENT AS SERVIC ES RENDERED BY ANY O THER LICENSED 29
94+HEALTH CARE PROVIDER . 30
95+ SENATE BILL 678 3
9296
93- (a) This section applies to individual, group, or blanket health insurance policies
94-and contracts delivered or issued for delivery in the State by insurers, nonprofit health
95-service plans, and health maintenance organizations [that provide coverage for patient
96-assessment regarding, and administration of, self–administered medications, maintenance WES MOORE, Governor Ch. 300
9797
98-– 3 –
99-injectable medications, and injectable medications for treatment of sexually transmitted
100-infections] THAT PROVIDE COVERAG E FOR SERVICES THAT ARE WITHIN THE LAWFU L
101-SCOPE OF PRACTICE OF A L ICENSED PHARMACIST .
98+ (B) REIMBURSEMENT FOR SER VICES PROVIDED UNDER SUBSECTION (A) OF 1
99+THIS SECTION MAY NOT BE CONDITIONED ON WH ETHER THE LICENSED P HARMACIST 2
100+IS: 3
102101
103- (b) An entity subject to this section shall provide coverage for services rendered
104-by a licensed pharmacist [under § 12–509 of the Health Occupations Article] ACTING
105-WITHIN THE PHARMACIS T’S LAWFUL SCOPE OF PR ACTICE to an individual who is
106-covered under a policy or contract issued or delivered by the entity, to the same extent as
107-services rendered by any other licensed health care practitioner[, for patient assessment
108-regarding and in administering self–administered medications, maintenance injectable
109-medications, or injectable medications for treatment of sexually transmitted infections].
102+ (1) EMPLOYED BY A PHYSICI AN, PHARMACY, OR FACILITY; OR 4
110103
111- (C) REIMBURSEMENT FOR SER VICES PROVIDED UNDER THIS SECTION MAY
112-NOT BE CONDITIONED O N WHETHER THE LICENS ED PHARMACIST IS :
104+ (2) ACTING UNDER A PHYSIC IAN’S ORDERS. 5
113105
114- (1) EMPLOYED BY A PHYSIC IAN, PHARMACY, OR FACILITY; OR
106+Article – Insurance 6
115107
116- (2) ACTING UNDER A PHYSI CIAN’S ORDERS.
108+15–716. 7
117109
118- SECTION 2. AND BE IT FURTHER ENACTED, That, to implement § 15 –151 of the
119-Health – General Article, as enacted by Section 1 of this Act, on or before January 1, 2024,
120-the Maryland Department of Health shall apply for and obtain from the U.S. Department
121-of Health and Human Services any necessary amendments to or waivers for the Maryland
122-Medical Assistance Program or the Maryland Children’s Health Program.
110+ (a) This section applies to individual, group, or blanket health insurance policies 8
111+and contracts delivered or issued for delivery in the State by insurers, nonprofit health 9
112+service plans, and health maintenance organizations [that provide coverage for patient 10
113+assessment regarding, and administration of, self–administered medications, maintenance 11
114+injectable medications, and injectable medications for treatment of sexually transmitted 12
115+infections] THAT PROVIDE COVERAG E FOR SERVICES THAT ARE WITHIN THE LAWFU L 13
116+SCOPE OF PRACTICE OF A L ICENSED PHARMACIST . 14
123117
124- SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all
125-policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or
126-after January 1, 2024.
118+ (b) An entity subject to this section shall provide coverage for services rendered 15
119+by a licensed pharmacist [under § 12–509 of the Health Occupations Article] ACTING 16
120+WITHIN THE PHARMACIS T’S LAWFUL SCOPE OF PR ACTICE to an individual who is 17
121+covered under a policy or contract issued or delivered by the entity, to the same extent as 18
122+services rendered by any other licensed health care practitioner[, for patient assessment 19
123+regarding and in administering self–administered medications, maintenance injectable 20
124+medications, or injectable medications for treatment of sexually transmitted infections]. 21
127125
128- SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall tak e effect
129-October 1, 2023.
126+ (C) REIMBURSEMENT FOR SER VICES PROVIDED UNDER THIS SECTION MAY 22
127+NOT BE CONDITIONED O N WHETHER THE LICENS ED PHARMACIST IS : 23
130128
131-Approved by the Governor, May 3, 2023.
129+ (1) EMPLOYED BY A PHYSIC IAN, PHARMACY, OR FACILITY; OR 24
130+
131+ (2) ACTING UNDER A PHYSI CIAN’S ORDERS. 25
132+
133+ SECTION 2. AND BE IT FURTHER ENACTED, That, to implement § 15 –151 of the 26
134+Health – General Article, as enacted by Section 1 of this Act, on or before January 1, 2024, 27
135+the Maryland Department of Health shall apply for and obtain from the U.S. Department 28
136+of Health and Human Services any necessary amendments to or waivers for the Maryland 29
137+Medical Assistance Program or the Maryland Children’s Health Program. 30
138+
139+ SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall apply to all 31
140+policies, contracts, and health benefit plans issued, delivered, or renewed in the State on or 32
141+after January 1, 2024. 33
142+ 4 SENATE BILL 678
143+
144+
145+ SECTION 3. 4. AND BE IT FURTHER ENACTED, That this Act shall tak e effect 1
146+October 1, 2023. 2
147+
148+
149+
150+
151+
152+Approved:
153+________________________________________________________________________________
154+ Governor.
155+________________________________________________________________________________
156+ President of the Senate.
157+________________________________________________________________________________
158+ Speaker of the House of Delegates.