MD State Legislature Hearings
Check back for updates on the next round of supported bill hearings.
Maryland 2022 Legislative Session
HB 1014/SB 690
HB 1014/SB 690 – PHARMACY BENEFITS MANAGERS: DEFINITIONS OF CARRIER, ERISA, & PURCHASER - BY DELEGATES KIPKE, KREBS, MORGAN, & SAAB / SENATOR READY
These bills will further expand the Rutledge decision to cover all aspects of ERISA PBMs under the Insurance Code. As you will recall, in last sessions HB 601, as enacted, certain provisions were extended to ERISA PBMs, but other provisions of the Insurance Code were exempted. This bill, as a result of the MIA study, would make all provisions of the Insurance Code PBM provisions applicable to ERISA PBMs as well.
HB 755/SB 689
HB 755 / SB 689 – PHARMACY BENEFITS MANAGERS: PROHIBITED ACTIONS - BY DELEGATES KREBS, BELCASTRO, CARR, JOHNSON, KIPKE, MORGAN, REILLY, SAAB, SZELIGA, K YOUNG / SENATOR READY
These bills contain certain practices that PBMs will be prohibited from carrying out. Specifically, spread pricing will be banned, different copays between affiliated and independent pharmacies will be banned, required use of mail-order pharmacies will be banned, and “any willing pharmacy provider” would be required of networks PBMs set up.
PROPOSED LEGISLATION OF INTEREST
HB 1006 – PHARMACY BENEFITS MANAGERS: NETWORK ADEQUACY, CREDENTIALING, & REIMBURSEMENT – BY DELEGATE KIPKE
This bill requires PBMs to maintain a reasonable and adequate network, and that a PBM cannot require a pharmacy to obtain additional accreditation beyond what the state requires, as a condition for participating in the network.
HB 1007 – MARYLAND MEDICAL ASSISTANCE PROGRAM & MANAGED CARE ORGANIZATIONS THAT USE PHARMACY BENEFITS MANAGERS: REIMBURSEMENT REQUIREMENTS – By DELEGATE KIPKE
This bill will apply to Medicaid reimbursements to pharmacies. It alters the reimbursement levels for drug products. Requires reimbursement at least equal to NADAC acquisition cost plus professional dispensing fee determined in accordance with the most recent in-state cost of dispensing survey.
HB 1008 – PHARMACY BENEFITS MANAGERS & PURCHASERS: BENEFICIARY CHOICE OF PHARMACY BY DELEGATE KIPKE
Prohibits a PBM from prohibiting a beneficiary from selecting a pharmacy of his choice or denying the pharmacy the right to participate in the network.
HB 1009 – HEALTH INSURANCE PHARMACY BENEFITS MANAGERS: REIMBURSEMENT & COST SHARING – BY DELEGATE KIPKE
Strengthens the prohibition on PBMs reimbursing a pharmacy in an amount less than the PBM reimburses itself or an affiliate; requires reimbursement at NADAC plus CMMS professional dispensing fee; contains other prohibitions on PBMs.
HB 1015 – PHARMACY BENEFITS MANAGERS: PROHIBITIONS RELATED TO REIMBURSEMENT & USE OF SPECIFIC PHARMACY REQUIREMENT – By DELEGATES K YOUNG & KERBS
Repealing the authority of a PBM to require a beneficiary to use a specific pharmacy for a specialty drug and altering the prohibition on PBMs to reimburse a pharmacy in an amount less than the PBM reimburses itself or an affiliate.
SB 661 – REIMBURSEMENT OF PHARMACIST FOR SERVICES RENDERED - BY SENATORS BENSON, BEIDLE, & SMITH
Altering definition of “health care provider” to include pharmacists related to malpractice claims, destruction of records, and HIV testing. Requires insurers and HMOs to reimburse pharmacists at same rate at same services provided by physician or nurse practitioner.
HB 973/SB 823
HB 973 / SB 823 – PHARMACY SERVICES ADMINISTRATIVE ORGANIZATIONS & PHARMACY BENEFITS MANAGERS CONTRACTS – BY DELEGATE KELLY / SENATOR KRAMER
Deals with PSAOs. Contracts between PSAOs and PBMs to be filed with Insurance Commissioner. Commissioner may approve or disapprove.
HB 1275 – PHARMACY BENEFITS MANAGERS: CONTRACTS WITH PHARMACY SERVICES ADMINISTRATIVE ORGANIZATIONS – By DELEGATE KIPKE
Deals with contracts with PSAOs.
HB 1219 – PHARMACISTS: STATUS AS HEALTHCARE PROVIDERS & REIMBURSEMENT – By DELEGATE BHANDARI
Altering definition of “health care provider” with respect to health care malpractice claims, medical records, and HIV testing; requiring Medicaid and certain insurers to provide coverage for pharmacists under certain circumstances.