Section 15-2004 – Registration Prerequisite to Agreements or Contracts
A pharmacy services administrative organization that has not registered with the Commissioner may not enter into an agreement or a contract with an independent pharmacy or a pharmacy benefits manager.
Section 15-2005 – Basis of Denial of Registration or Suspension or Revocation
Subject to the applicable hearing provisions of Title 2 of this article, the Commissioner may deny a registration to a pharmacy services administrative organization or refuse to renew, suspend, or revoke the registration of a pharmacy services administrative organization if the pharmacy services administrative organization, or an officer, a director, or an employee of the […]
Section 15-2006 – Recordkeeping Requirements
A pharmacy services administrative organization shall maintain adequate books and records regarding each independent pharmacy for which the pharmacy services administrative organization provides services as a pharmacy services administrative organization: (1) in accordance with prudent standards of record keeping; (2) for the duration of the agreement between the pharmacy services administrative organization and the independent pharmacy; and […]
Section 15-2007 – Review by Commissioner — Expense
(a) Whenever the Commissioner considers it advisable, the Commissioner may examine the affairs, transactions, accounts, and records of a registered pharmacy services administrative organization. (b) The examination shall be conducted in accordance with § 2–207 of this article. (c) The expense of the examination shall be paid in accordance with § 2–208 of this article. (d) The reports of […]
Section 15-2008 – Adoption of Regulations
The Commissioner may adopt regulations to implement this subtitle.
Section 15-1642 – Violations; Enforcement
(a) It is a violation of this subtitle for a pharmacy benefits manager to: (1) misrepresent pertinent facts or policy provisions that relate to a claim or the compensation program at issue in a complaint or an appeal of a decision regarding a complaint; (2) refuse to pay a claim for an arbitrary or capricious reason based on […]
Section 15-2009 – Review Authority Not Diminished
This subtitle may not be construed to diminish the authority of the Office of the Attorney General or the Commissioner to obtain information relating to a pharmacy services administrative organization and use the information in any proceeding.
Section 15-1624 – Rebate Sharing Contract
(a) If a purchaser has a rebate sharing contract, a pharmacy benefits manager shall offer to provide the purchaser a report for each fiscal quarter and each fiscal year that contains the amount of the: (1) net revenue of the pharmacy benefits manager from sales of prescription drugs to purchasers made through the pharmacy benefits manager’s network […]
Section 15-1625 – Effect of Part
This part does not diminish the authority of the Office of the Attorney General or the Commissioner to obtain information relating to a pharmacy benefits manager and use the information in any proceeding.
Section 15-1628 – Required Disclosures by Pharmacy Benefits Manager; Filing Requirements for Contract or Amendment to Contract
(a) For disputes regarding cost pricing and reimbursement under a participating pharmacy contract, each participating pharmacy contract must include a process to appeal, investigate, and resolve disputes regarding cost pricing and reimbursement that includes: (1) a requirement that an appeal be filed by the contract pharmacy not later than 21 days after: (i) the date a direct or […]