summary
Introduced
02/01/2023
02/01/2023
In Committee
02/01/2023
02/01/2023
Crossed Over
Passed
Dead
04/10/2023
04/10/2023
Introduced Session
2023 Regular Session
Bill Summary
AN ACT concerning Pharmacy Benefits Managers - Prohibited Actions FOR the purpose of prohibiting a pharmacy benefits manager from taking certain actions related to pricing, the participation of a pharmacy or pharmacist in a policy or contract with the pharmacy benefits manager, fees, and the use of a mail order pharmacy by beneficiaries; providing that certain provisions of this Act apply to pharmacy benefits managers that contract with managed care organizations in the same manner as they apply to pharmacy benefits managers that contract with carriers; prohibiting all pharmacy benefits managers from taking certain actions related to the use of specific pharmacies or entities to fill prescriptions, the provision and discussion of certain price and cost share information by pharmacies and pharmacists, and the sale of certain alternative drugs; and generally relating to pharmacy benefits managers. BY adding to Article - Health - General Section 15-102.3(k) Annotated Code of Maryland (2019 Replacement Volume and 2022 Supplement) BY repealing and reenacting, without amendments, Article - Insurance Section 15-1601(a) Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement) BY repealing and reenacting, with amendments, Article - Insurance Section 15-1601(s), (u), (v), and (w), 15-1611, and 15-1611.1 Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement) HOUSE BILL 539 BY adding to Article - Insurance Section 15-1601(u) Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement)
AI Summary
This bill prohibits pharmacy benefits managers (PBMs) from engaging in certain practices, such as spread pricing, denying pharmacies the right to participate in PBM contracts if they meet the terms, taking more than 30 days to review pharmacy applications, setting different fees for beneficiaries based on pharmacy affiliation, requiring beneficiaries to use specific pharmacies or mail-order pharmacies, and restricting pharmacies or pharmacists from providing certain price and cost-sharing information to beneficiaries. The bill also applies these provisions to PBMs that contract with managed care organizations in the same way as those that contract with carriers. The bill takes effect on January 1, 2024, and applies to all policies or contracts issued, delivered, or renewed in the state on or after that date.
Committee Categories
Health and Social Services
Sponsors (2)
Last Action
Withdrawn by Sponsor (on 03/16/2023)
bill text
bill summary
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bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/HB0539?ys=2023RS |
| Vote Image | https://mgaleg.maryland.gov/2023RS/votes_comm/hb0539_hgo.pdf |
| BillText | https://mgaleg.maryland.gov/2023RS/bills/hb/hb0539f.pdf |
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