EXPLANATION: CAPITALS INDICATE MAT TER ADDED TO EXISTING LA W.
[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.
*hb0879*
HOUSE BILL 879
J5 4lr2511
CF SB 595
By: Delegates S. Johnson and A. Johnson, A. Johnson, Alston, Bagnall, Bhandari,
Chisholm, Cullison, Guzzone, Hill, Hutchinson, Kaiser, Kipke, R. Lewis,
Lopez, Martinez, M. Morgan, Pena–Melnyk, Reilly, Rosenberg, Szeliga,
Taveras, White Holland, and Woods
Introduced and read first time: February 2, 2024
Assigned to: Health and Government Operations
Committee Report: Favorable with amendments
House action: Adopted
Read second time: March 1, 2024
CHAPTER ______
AN ACT concerning 1
Health Benefit Plans – Calculation of Cost Sharing Contribution – 2
Requirements and Prohibitions 3
FOR the purpose of requiring certain insurers, nonprofit health service plans, and health 4
maintenance organizations to include certain discounts, financial assistance 5
payments, product vouchers, and other out–of–pocket expenses made by or on behalf 6
of an insured or enrollee when calculating certain cost–sharing contributions for 7
certain prescription drugs; requiring persons that provide certain discounts, 8
financial assistance payments, product vouchers, or other out–of–pocket expenses to 9
notify an insured or enrollee of certain information; providing that a violation of a 10
certain provision of this Act is considered a violation of the Consumer Protection Act; 11
administrators, carriers, and pharmacy benefits managers to include certain cost 12
sharing amounts paid by or on behalf of an enrollee or a beneficiary when calculating 13
the enrollee’s or beneficiary’s contribution to a cost sharing requirement; requiring 14
administrators, carriers, and pharmacy benefits managers to include certain cost 15
sharing amounts for certain high deductible health plans after an enrollee or a 16
beneficiary satisfies a certain requirement; prohibiting administrators, carriers, and 17
pharmacy benefits managers from directly or indirectly setting, altering, 18
implementing, or conditioning the terms of certain coverage based on certain 19
information; and generally relating to the calculation of cost sharing requirements. 20
BY adding to 21 2 HOUSE BILL 879
Article – Insurance 1
Section 15–118.1 and 15–1611.3 2
Annotated Code of Maryland 3
(2017 Replacement Volume and 2023 Supplement) 4
BY repealing and reenacting, with amendments, 5
Article – Insurance 6
Section 15–1601 7
Annotated Code of Maryland 8
(2017 Replacement Volume and 2023 Supplement) 9
Preamble 10
WHEREAS, Residents of Maryland frequently rely on State–regulated commercial 11
health insurance carriers to secure access to the prescription medicines needed to protect 12
their health; and 13
WHEREAS, Commercial health insurance designs increasingly require patients to 14
bear significant out–of–pocket costs for their prescription medicines; and 15
WHEREAS, High out–of–pocket costs on prescription medicines impact the ability 16
of patients to start new and necessary medicines and to stay adherent to their current 17
prescriptions; and 18
WHEREAS, High or unpredictable cost sharing requirements are a main driver of 19
elevated patient out–of–pocket costs and allow health insurance carriers to capture 20
discounts and price concessions that are intended to benefit patients at the pharmacy 21
counter; and 22
WHEREAS, Health insurance carriers unfairly increase cost sharing burdens on 23
patients by refusing to count third–party assistance toward patients’ cost sharing 24
contributions; and 25
WHEREAS, The burdens of high or unpredictable cost sharing requirements are 26
borne disproportionately by patients with chronic or debilitating conditions; and 27
WHEREAS, Restrictions are needed on the ability of health insurance carriers and 28
their intermediaries to use unfair cost sharing designs to retain rebates and price 29
concessions that instead should be directly passed on to patients as cost savings; and 30
WHEREAS, Patients need equitable and accessible health coverage that does not 31
impose unfair cost sharing burdens on them; now, therefore, 32
SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 33
That the Laws of Maryland read as follows: 34
Article – Insurance 35 HOUSE BILL 879 3
15–118.1. 1
(A) (1) THIS SECTION APPLIES TO: 2
(I) INSURERS AND NONPROF IT HEALTH SERVICE PL ANS THAT 3
PROVIDE HOSPITAL , MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS 4
ON AN EXPENSE –INCURRED BASIS UNDER HEALTH INSURANCE POL ICIES OR 5
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE; AND 6
(II) HEALTH MAINTENANCE O RGANIZATIONS THAT PR OVIDE 7
HOSPITAL, MEDICAL, OR SURGICAL BENEFITS TO INDIVIDUALS OR GR OUPS UNDER 8
CONTRACTS THAT ARE I SSUED OR DELIVERED I N THE STATE. 9
(2) AN INSURER, A NONPROFIT HEALTH S ERVICE PLAN, OR A HEALTH 10
MAINTENANCE ORGANIZA TION THAT PROVIDES C OVERAGE FOR PRESCRIP TION 11
DRUGS THR OUGH A PHARMACY BENE FITS MANAGER IS SUBJ ECT TO THE 12
REQUIREMENTS OF THIS SECTION. 13
(B) (1) SUBJECT TO PARAGRAPH (2) OF THIS SUBSECTION , WHEN 14
CALCULATING AN INSUR ED’S OR ENROLLEE ’S CONTRIBUTION TO TH E INSURED’S OR 15
ENROLLEE’S COINSURANCE , COPAYMENT , DEDUCTIBLE, OR OUT–OF–POCKET 16
MAXIMUM UNDER THE IN SURED’S OR ENROLLEE ’S HEALTH BENEFIT PLA N, AN 17
ENTITY SUBJECT TO TH IS SECTION SHALL INC LUDE ANY DISCOUNT , FINANCIAL 18
ASSISTANCE PAYMENT , PRODUCT VOUCHER , OR OTHER OUT –OF–POCKET EXPENSE 19
MADE BY OR ON BEHALF OF THE INSU RED OR ENROLLEE FOR A PRESCRIPTION 20
DRUG: 21
(I) THAT IS COVERED UNDE R THE INSURED ’S OR ENROLLEE ’S 22
HEALTH BENEFIT PLAN ; AND 23
(II) 1. THAT DOES NOT HAVE A N AB–RATED GENERIC 24
EQUIVALENT DRUG OR A N INTERCHANGEABLE BI OLOGICAL PRODUCT PRE FERRED 25
UNDER THE HEALTH BENEFIT PLAN ’S FORMULARY ; OR 26
2. A. THAT HAS AN AB–RATED GENERIC 27
EQUIVALENT DRUG OR A N INTERCHANGEABLE BI OLOGICAL PRODUCT PRE FERRED 28
UNDER THE HEALTH BEN EFIT PLAN’S FORMULARY ; AND 29
B. FOR WHICH THE INSURE D OR ENROLLEE ORIGIN ALLY 30
OBTAINED COVE RAGE THROUGH PRIOR A UTHORIZATION , A STEP THERAPY 31
PROTOCOL, OR THE EXCEPTION OR APPEAL PROCESS OF TH E ENTITY SUBJECT TO 32
THIS SECTION. 33
4 HOUSE BILL 879
(2) IF AN INSURED OR ENRO LLEE IS COVERED UNDE R A 1
HIGH–DEDUCTIBLE HEALTH PL AN, AS DEFINED IN 26 U.S.C. § 223, THIS 2
SUBSECTION DOES NOT APPL Y TO THE DEDUCTIBLE REQUIREMENT OF THE 3
HIGH–DEDUCTIBLE HEALTH PL AN. 4
(C) (1) A PERSON THAT PROVIDES A DISCOUNT, FINANCIAL ASSISTANCE 5
PAYMENT, PRODUCT VOUCHER , OR OTHER OUT –OF–POCKET EXPENSE MADE BY OR 6
ON BEHALF OF THE INS URED OR ENROL LEE THAT IS USED IN THE CALCULATION OF 7
THE INSURED’S OR ENROLLEE ’S CONTRIBUTION TO TH E INSURED’S OR ENROLLEE ’S 8
COINSURANCE , COPAYMENT , DEDUCTIBLE, OR OUT–OF–POCKET MAXIMUM SHALL 9
NOTIFY THE INSURED O R ENROLLEE OF : 10
(I) THE MAXIMUM DOLLAR A MOUNT OF THE DI SCOUNT, 11
FINANCIAL ASSISTANCE PAYMENT, PRODUCT VOUCHER , OR OTHER 12
OUT–OF–POCKET EXPENSE ; AND 13
(II) THE EXPIRATION DATE FOR THE DISCOUNT , FINANCIAL 14
ASSISTANCE PAYMENT , PRODUCT VOUCHER , OR OTHER OUT –OF–POCKET EXPENSE . 15
(2) A VIOLATION OF PARAGRA PH (1) OF THIS SUBSECTION IS A 16
VIOLATION OF THE CONSUMER PROTECTION ACT. 17
(A) (1) IN THIS SECTION THE F OLLOWING WORDS HAVE THE MEANINGS 18
INDICATED. 19
(2) “ADMINISTRATOR ” HAS THE MEANING STAT ED IN § 8–301 OF THIS 20
ARTICLE. 21
(3) “CARRIER” MEANS AN ENTITY SUBJ ECT TO THE JURISDICTION OF 22
THE COMMISSIONER THAT CON TRACTS, OR OFFERS TO CONTRAC T, TO PROVIDE, 23
DELIVER, ARRANGE FOR , PAY FOR, OR REIMBURSE ANY OF THE COSTS OF HEALTH 24
CARE SERVICES UNDER A HEALTH BENEFIT PLA N IN THE STATE. 25
(4) “COST SHARING ” MEANS ANY COPAYM ENT, COINSURANCE , 26
DEDUCTIBLE, OR OTHER SIMILAR CHA RGE REQUIRED OF AN E NROLLEE FOR A 27
HEALTH CARE SERVICE COVERED BY A HEALTH BENEFIT PLAN , INCLUDING A 28
PRESCRIPTION DRUG , AND PAID BY OR ON BE HALF OF THE ENROLLEE . 29
(5) “ENROLLEE” MEANS AN INDIVIDUAL ENTITLED TO PAYMENT FOR 30
HEALTH CARE SERVICES FROM AN ADMINISTRATO R OR A CARRIER. 31
(6) “HEALTH BENEFIT PLAN ” MEANS A POLICY , A CONTRACT , A 32
CERTIFICATION , OR AN AGREEMENT OFFE RED OR ISSUED BY AN ADMINISTRATOR 33 HOUSE BILL 879 5
OR A CARRIER TO PROV IDE, DELIVER, ARRANGE FOR , PAY FOR, OR REIMBURSE ANY 1
OF THE COSTS OF HEAL TH CARE SERVICES . 2
(7) “HEALTH CARE SERVICE ” MEANS AN ITEM OR SER VICE PROVIDED 3
TO AN INDIVIDUAL FOR THE PURPOSE OF PREVE NTING, ALLEVIATING, CURING, OR 4
HEALING HUMAN ILLNES S, INJURY, OR PHYSICAL DISABILI TY. 5
(B) THE ANNUAL LIMITATION ON COST SHARING PROVIDE D FOR UNDER 42 6
U.S.C. § 18022(C)(1) SHALL APPLY TO ALL H EALTH CARE SERVICES COVERED 7
UNDER A HEALTH BENEF IT PLAN OFFERED OR I SSUED BY AN ADMINIST RATOR OR A 8
CARRIER IN THE STATE. 9
(C) (1) SUBJECT TO PARAGRAPHS (2) AND (3) OF THIS SUBSECTION , 10
WHEN CALCULATING AN ENROLLEE’S CONTRIBUTION TO AN APPLICABLE COST 11
SHARING REQUIREMENT , AN ADMINISTRATOR OR A CARRIER SHALL INCL UDE COST 12
SHARING AMOUNTS PAID BY THE ENROLLEE OR O N BEHALF OF THE ENRO LLEE BY 13
ANOTHER PERSON . 14
(2) IF THE APPLICATION OF THE REQUIREMENT UNDE R PARAGRAPH 15
(1) OF THIS SUBSECTION W OULD RESULT IN HEALT H SAVINGS ACCOUNT 16
INELIGIBILITY UNDER § 223 OF THE INTERNAL REVENUE CODE, THE REQUIREMENT 17
SHALL APPLY TO HEALT H SAVINGS ACCOUNT –QUALIFIED HIGH DEDUC TIBLE 18
HEALTH PLANS WITH RESPE CT TO THE DEDUCTIBLE OF THE PLAN AFTER TH E 19
ENROLLEE SATISFIES T HE MINIMUM DEDUCTIBL E UNDER § 223 OF THE INTERNAL 20
REVENUE CODE. 21
(3) FOR ITEMS OR SERVICES THAT ARE PREVENTIVE CARE IN 22
ACCORDANCE WITH § 223(C)(2)(C) OF THE INTERNAL REVENUE CODE, THE 23
REQUIREMENTS OF THIS SUBSECTION SHALL APP LY REGARDLESS OF WHE THER THE 24
ENROLLEE SATISFIES T HE MINIMUM DEDUCTIBL E UNDER § 223 OF THE INTERNAL 25
REVENUE CODE. 26
(D) AN ADMINISTRATOR OR A CARRIER MAY NOT DIRE CTLY OR INDIRECTLY 27
SET, ALTER, IMPLEMENT, OR CONDITION THE TER MS OF HEALTH BENEFIT PLAN 28
COVERAGE, INCLUDING THE BENEFI T DESIGN, BASED IN WHOLE OR IN PART ON 29
INFORMATION ABOUT TH E AVAILABILITY OR AM OUNT OF FINANCIAL OR PRODUCT 30
ASSISTANCE AVAILABLE FOR A PRESCRIPTION D RUG. 31
(E) THE COMMISSION ER MAY ADOPT REGULAT IONS TO CARRY OUT TH IS 32
SECTION. 33
15–1601. 34
6 HOUSE BILL 879
(a) In this subtitle the following words have the meanings indicated. 1
(b) “Agent” means a pharmacy, a pharmacist, a mail order pharmacy, or a 2
nonresident pharmacy acting on behalf or at the direction of a pharmacy benefits manager. 3
(c) “Beneficiary” means an individual who receives prescription drug coverage or 4
benefits from a purchaser. 5
(d) (1) “Carrier” means the State Employee and Retiree Health and Welfare 6
Benefits Program, an insurer, a nonprofit health service plan, [or] a health maintenance 7
organization, OR ANY OTHER ENTITY SUBJECT TO THE JURIS DICTION OF THE 8
COMMISSIONER that: 9
(i) provides prescription drug coverage or benefits in the State; and 10
(ii) enters into an agreement with a pharmacy benefits manager for 11
the provision of pharmacy benefits management services. 12
(2) “Carrier” does not include a person that provides prescription drug 13
coverage or benefits through plans subject to ERISA and does not provide prescription drug 14
coverage or benefits through insurance, unless the person is a multiple employer welfare 15
arrangement as defined in § 514(b)(6)(a)(ii) of ERISA. 16
(e) “Compensation program” means a program, policy, or process through which 17
sources and pricing information are used by a pharmacy benefits manager to determine the 18
terms of payment as stated in a participating pharmacy contract. 19
(f) “Contracted pharmacy” means a pharmacy that participates in the network of 20
a pharmacy benefits manager through a contract with: 21
(1) the pharmacy benefits manager; or 22
(2) a pharmacy services administration organization or a group purchasing 23
organization. 24
(G) “COST SHARING ” MEANS ANY COPAYMENT , COINSURANCE , 25
DEDUCTIBLE, OR OTHER SIMILAR CHA RGE REQUIRED OF A BE NEFICIARY FOR A 26
HEALTH CARE SERVICE COVERED BY A HEALTH BENEFIT PLAN , INCLUDING A 27
PRESCRIPTION DRUG , AND PAID BY OR ON BE HALF OF THE BENEFICI ARY. 28
[(g)] (H) “ERISA” has the meaning stated in § 8–301 of this article. 29
[(h)] (I) “Formulary” means a list of prescription drugs used by a purchaser. 30
(J) “HEALTH BENEFIT PLAN ” MEANS A POLICY , A CONTRACT , A 31
CERTIFICATION , OR AN AGREEMENT OFFE RED OR ISSUED BY AN ADMINISTRATOR 32 HOUSE BILL 879 7
OR A CARRIER TO PROV IDE, DELIVER, ARRANGE FOR , PAY FOR, OR REIMBURSE ANY 1
PORTION OF THE COST OF HEALTH CARE SERVICES . 2
(K) “HEALTH CARE SERVICE ” MEANS AN ITEM OR SER VICE PROVIDED TO AN 3
INDIVIDUAL FOR THE P URPOSE OF PREVENTING , ALLEVIATING, CURING, OR 4
HEALING HUMAN ILLNES S, INJURY, OR PHYSICAL DISABILI TY. 5
[(i)] (L) (1) “Manufacturer payments” means any compensation or 6
remuneration a pharmacy benefits manager receives from or on behalf of a pharmaceutical 7
manufacturer. 8
(2) “Manufacturer payments” includes: 9
(i) payments received in accordance with agreements with 10
pharmaceutical manufacturers for formulary placement and, if applicable, drug utilization; 11
(ii) rebates, regardless of how categorized; 12
(iii) market share incentives; 13
(iv) commissions; 14
(v) fees under products and services agreements; 15
(vi) any fees received for the sale of utilization data to a 16
pharmaceutical manufacturer; and 17
(vii) administrative or management fees. 18
(3) “Manufacturer payments” does not include purchase discounts based on 19
invoiced purchase terms. 20
[(j)] (M) “Nonprofit health maintenance organization” has the meaning stated 21
in § 6–121(a) of this article. 22
[(k)] (N) “Nonresident pharmacy” has the meaning stated in § 12–403 of the 23
Health Occupations Article. 24
[(l)] (O) “Participating pharmacy contract” means a contract filed with the 25
Commissioner in accordance with § 15–1628(b) of this subtitle. 26
[(m)] (P) “Pharmacist” has the meaning stated in § 12–101 of the Health 27
Occupations Article. 28
8 HOUSE BILL 879
[(n)] (Q) “Pharmacy” has the meaning stated in § 12 –101 of the Health 1
Occupations Article. 2
[(o)] (R) “Pharmacy and therapeutics committee” means a committee 3
established by a pharmacy benefits manager to: 4
(1) objectively appraise and evaluate prescription drugs; and 5
(2) make recommendations to a purchaser regarding the selection of drugs 6
for the purchaser’s formulary. 7
[(p)] (S) (1) “Pharmacy benefits management services” means: 8
(i) the [procurement of prescription drugs at a negotiated rate for 9
dispensation within the State to beneficiaries] NEGOTIATION OF THE P RICE OF 10
PRESCRIPTION DRUGS , INCLUDING THE NEGOTIAT ING AND CONTRACTING FOR 11
DIRECT AND INDIRECT REBATES, DISCOUNTS, OR OTHER PRICE CONCE SSIONS; 12
(ii) the administration or management of prescription drug coverage 13
provided by a purchaser for beneficiaries; [and] 14
(iii) any of the following services provided with regard to the 15
administration of prescription drug coverage: 16
1. mail service pharmacy; 17
2. claims processing, retail network management, and 18
payment of claims to pharmacies for prescription drugs dispensed to beneficiaries; 19
3. clinical formulary development and management services; 20
4. rebate contracting and administration; 21
5. patient compliance, therapeutic intervention, and generic 22
substitution programs; [or] 23
6. disease management programs; 24
7. DRUG UTILIZATION REV IEW; OR 25
8. ADJUDICATION OF APPE ALS OR GRIEVANCES 26
RELATED TO A PRESCRI PTION DRUG BENEFIT ; 27
HOUSE BILL 879 9
(IV) THE PERFORMANCE OF A DMINISTRATIVE , MANAGERIAL , 1
CLINICAL, PRICING, FINANCIAL, REIMBURSEMENT , DATA ADMINISTRATION OR 2
REPORTING, OR BILLING SERVICES; OR 3
(V) OTHER SERVICES DEFIN ED BY THE COMMISSIONER IN 4
REGULATION . 5
(2) “Pharmacy benefits management services” does not include any service 6
provided by a nonprofit health maintenance organization that operates as a group model, 7
provided that the service: 8
(i) is provided solely to a member of the nonprofit health 9
maintenance organization; and 10
(ii) is furnished through the internal pharmacy operations of the 11
nonprofit health maintenance organization. 12
[(q)] (T) “Pharmacy benefits manager” means: 13
(1) a person that [performs], IN ACCORDANCE WITH A WRITTEN 14
AGREEMENT WITH A PUR CHASER, EITHER DIRECTLY OR I NDIRECTLY, PROVIDES 15
ONE OR MORE pharmacy benefits management services; OR 16
(2) AN AGENT OR OTHER PR OXY OR REPRESENTATIVE , CONTRACTOR , 17
INTERMEDIARY , AFFILIATE, SUBSIDIARY, OR RELATED ENTITY OF A PERSON THAT 18
FACILITATES, PROVIDES, DIRECTS, OR OVERSEES THE PROV ISION OF PHARMACY 19
BENEFITS MANAGEMENT SERVICES. 20
[(r)] (U) “Proprietary information” means: 21
(1) a trade secret; 22
(2) confidential commercial information; or 23
(3) confidential financial information. 24
[(s)] (V) “Purchaser” means a person that offers a plan or program in the State, 25
including the State Employee and Retiree Health and Welfare Benefits Program, that: 26
(1) provides prescription drug coverage or benefits in the State; and 27
(2) enters into an agreement with a pharmacy benefits manager for the 28
provision of pharmacy benefits management services. 29
10 HOUSE BILL 879
[(t)] (W) “Rebate sharing contract” means a contract between a pharmacy 1
benefits manager and a purchaser under which the pharmacy benefits manager agrees to 2
share manufacturer payments with the purchaser. 3
[(u)] (X) (1) “Therapeutic interchange” means any change from one 4
prescription drug to another. 5
(2) “Therapeutic interchange” does not include: 6
(i) a change initiated pursuant to a drug utilization review; 7
(ii) a change initiated for patient safety reasons; 8
(iii) a change required due to market unavailability of the currently 9
prescribed drug; 10
(iv) a change from a brand name drug to a generic drug in accordance 11
with § 12–504 of the Health Occupations Article; or 12
(v) a change required for coverage reasons because the originally 13
prescribed drug is not covered by the beneficiary’s formulary or plan. 14
[(v)] (Y) “Therapeutic interchange solicitation” means any communication by a 15
pharmacy benefits manager for the purpose of requesting a therapeutic interchange. 16
[(w)] (Z) “Trade secret” has the meaning stated in § 11–1201 of the Commercial 17
Law Article. 18
15–1611.3. 19
(A) THIS SECTION APPLIES ONLY TO A PHARMACY B ENEFITS MANAGER 20
THAT PROVIDES PHARMA CY BENEFITS MANAGEME NT SERVICES ON BEHAL F OF A 21
CARRIER. 22
(B) (1) SUBJECT TO PARAGRAPHS (2) AND (3) OF THIS SUBSECTION , 23
WHEN CALCULATING A B ENEFICIARY’S CONTRIBUTION TO AN APPLICABLE COST 24
SHARING REQUIREMENT , A PHARMACY BENEFITS MANAGER SHALL INCLUD E COST 25
SHARING AMOUNTS PAID BY THE BENEFICIARY O N BEHALF OF THE BENE FICIARY BY 26
ANOTHER PERSON . 27
(2) IF THE APPLICATION OF THE REQUIREMENT UNDE R PARAGRAPH 28
(1) OF THIS SUBSECTION W OULD RESULT IN HEALT H SAVINGS ACCOUNT 29
INELIGIBILITY UNDER § 223 OF THE INTERNAL REVENUE CODE, THE REQUIREMENT 30
SHALL APPLY TO HEALT H SAVINGS ACCOUNT –QUALIFIED HIGH DEDUC TIBLE 31
HEALTH PLANS WITH RE SPECT TO THE DEDUCTI BLE OF THE PLAN AFTE R THE 32 HOUSE BILL 879 11
BENEFICIARY SATISFIE S THE MINIMUM DEDUCT IBLE UNDER § 223 OF THE 1
INTERNAL REVENUE CODE. 2
(3) FOR ITEMS OR SERVICES THAT ARE PREVENTIVE CARE IN 3
ACCORDANCE WITH § 223(C)(2)(C) OF THE INTERNAL REVENUE CODE, THE 4
REQUIREMENTS OF THIS SUBSECTION SHALL APP LY REGARDLESS OF WHE THER THE 5
BENEFICIARY SATISFIE S THE MINIMUM DEDUCT IBLE UNDER § 223 OF THE 6
INTERNAL REVENUE CODE. 7
(C) A PHARMACY BENEFITS MA NAGER MAY NOT DIRECT LY OR INDIRECTLY 8
SET, ALTER, IMPLEMENT, OR CONDITION THE TER MS OF HEALTH BENEFIT PLAN 9
COVERAGE, INCLUDING THE BENEFI T DESIGN, BASED IN WHOLE OR IN PART ON 10
INFORMATION ABOUT TH E AVAILABILITY OR AM OUNT OF FINANCIAL OR PRODUCT 11
ASSISTANCE AVAILABLE FOR A PRESCRIPTI ON DRUG. 12
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall apply to all 13
policies, contracts, and health plans issued, delivered, or renewed in the State on or after 14
January 1, 2025. 15
SECTION 3. AND BE IT FURTHER ENACTED, That this Act shall take effect 16
January 1, 2025. 17
Approved:
________________________________________________________________________________
Governor.
________________________________________________________________________________
Speaker of the House of Delegates.
________________________________________________________________________________
President of the Senate.