summary
Introduced
02/15/2023
02/15/2023
In Committee
03/14/2023
03/14/2023
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) SENATE BILL 896 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. It prohibits PBMs from: 1) using "spread pricing" (where the PBM charges the purchaser more than it pays the pharmacy), 2) denying pharmacies the right to participate in a PBM's policy or contract if the pharmacy meets the terms, 3) taking more than 30 days to review a pharmacy's application to participate, and 4) setting different copay fees based on whether the pharmacy is independent or part of a chain. The bill also prohibits PBMs from requiring beneficiaries to use a specific pharmacy or mail-order pharmacy owned by or affiliated with the PBM. The provisions of the bill apply to PBMs that contract with both carriers and managed care organizations, and the bill takes effect on January 1, 2024.
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
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bill summary
| Document Type | Source Location |
|---|---|
| State Bill Page | https://mgaleg.maryland.gov/mgawebsite/Legislation/Details/SB0896?ys=2023RS |
| BillText | https://mgaleg.maryland.gov/2023RS/bills/sb/sb0896f.pdf |
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