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MD SB895
MD SB895Pharmacy Benefits Administration - Maryland Medical Assistance Program and Pharmacy Benefits Managers
summary
Introduced
02/15/2023
02/15/2023
In Committee
03/08/2023
03/08/2023
Crossed Over
Passed
Dead
04/10/2023
04/10/2023
Introduced Session
2023 Regular Session
Bill Summary
AN ACT concerning Pharmacy Benefits Administration - Maryland Medical Assistance Program and Pharmacy Benefits Managers 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; and generally relating to pharmacy benefits administration. 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 SENATE BILL 895 Section 15-1632 Annotated Code of Maryland (2017 Replacement Volume and 2022 Supplement)
AI Summary
This bill proposes to:
1. Establish minimum reimbursement levels for the Maryland Medical Assistance Program (Medicaid) for generic drug products, which must be at least equal to the National Average Drug Acquisition Cost (NADAC) of the generic product plus the Medicaid program's professional dispensing fee.
2. Require pharmacy benefits managers (PBMs) that contract with managed care organizations to reimburse pharmacies an amount that is at least equal to the NADAC plus the Medicaid professional dispensing fee.
3. Expand the definition of "purchaser" under the law regulating PBMs to include insurers, nonprofit health service plans, and health maintenance organizations that provide prescription drug coverage in Maryland and contract with a PBM.
The bill is an emergency measure and will take effect immediately upon enactment.
Committee Categories
Budget and Finance
Sponsors (2)
Last Action
Senate Finance Hearing (13:00:00 3/21/2023 ) (on 03/21/2023)
bill text
bill summary
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0895?ys=2023RS |
| BillText | https://mgaleg.maryland.gov/2023RS/bills/sb/sb0895f.pdf |
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