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Bill > HB382


MD HB382

MD HB382
Maryland Department of Health and Prescription Drug Affordability Board - Managed Care Organizations and Prescription Drug Claims - Study


summary

Introduced
01/26/2023
In Committee
04/03/2023
Crossed Over
03/15/2023
Passed
04/05/2023
Dead
Signed/Enacted/Adopted
04/24/2023

Introduced Session

2023 Regular Session

Bill Summary

AN ACT concerning Pharmacy Benefits Administration - Maryland Medical Assistance Program and Pharmacy Benefits Managers Maryland Department of Health and Prescription Drug Affordability Board - Managed Care Organizations and Prescription Drug Claims - Study FOR the purpose of altering the reimbursement levels for drug products that the Maryland Medical Assistance Program is required to establish and that pharmacy benefits managers that contract with a pharmacy on behalf of a managed care organization are required to reimburse the pharmacy; altering the definition of “purchaser” for purposes of certain provisions of law regulating pharmacy benefits managers to include certain insurers, nonprofit health services plans, and health maintenance organizations requiring the Maryland Department of Health and the Prescription Drug Affordability Board jointly to study certain information regarding the payment of prescription drug claims under the Maryland Medical Assistance Program during certain calendar years and how to address certain inconsistencies; and generally relating to pharmacy benefits administration managed care organizations and the payment of prescription drug claims. BY repealing and reenacting, with amendments, Article - Health - General Section 15-118(b) Annotated Code of Maryland (2019 Replacement Volume and 2022 Supplement) BY adding to Article - Health - General Section 15-118(f) Annotated Code of Maryland (2019 Replacement Volume and 2022 Supplement) BY repealing and reenacting, with amendments, Article - Insurance Section 15-1601(s) Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement) BY adding to Article - Insurance Section 15-1632 Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement)

AI Summary

This bill requires the Maryland Department of Health and the Prescription Drug Affordability Board to jointly study the total amount managed care organizations in the state paid pharmacies for prescription drug claims in 2021 and 2022, and what the total amount would have been if the claims were reimbursed at the Maryland Medical Assistance Program fee-for-service rates. The bill also directs the Department and Board to recommend a methodology for determining the most accurate ingredient cost of a drug and an appropriate dispensing fee to address any inconsistencies in the amounts. The study findings must be reported to the Maryland Medicaid Administration and legislative committees by October 31, 2023.

Committee Categories

Budget and Finance, Health and Social Services

Sponsors (23)

Last Action

Approved by the Governor - Chapter 217 (on 04/24/2023)

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