Md. Code Ann., Ins. § 15-1628.3
Redline — January 1, 2020 → current.View current text →
Current — January 1, 2022
As of January 1, 2020
A pharmacy benefits manager or a purchaser may not directly or indirectly charge a contracted pharmacy, or hold a contracted pharmacy responsible for, a fee or performance–based reimbursement related to the adjudication of a claim or an incentive program that is not:
(a) A pharmacy benefits manager or a carrier may not directly or indirectly charge a contracted pharmacy, or hold a contracted pharmacy responsible for, a fee or performance–based reimbursement related to the adjudication of a claim or an incentive program.
(1) specifically enumerated by the pharmacy benefits manager or purchaser at the time of claim processing; or
(2) reported on the initial remittance advice of an adjudicated claim.
(b) A pharmacy benefits manager or carrier may not make or allow any reduction in payment for pharmacy services by a pharmacy benefits manager or carrier or directly or indirectly reduce a payment for a pharmacy service under a reconciliation process to an effective rate of reimbursement, including generic effective rates, brand effective rates, direct and indirect remuneration fees, or any other reduction or aggregate reduction of payments.
Official source: Maryland General Assembly. Reproduced from public-domain Maryland statutes; confirm against the official source for the current text. Not legal advice.