Section 15-1636 – Cancellation and Reversal
(a) A pharmacy benefits manager or its agent shall cancel and reverse a therapeutic interchange on written or verbal instructions from a prescriber, the beneficiary, or the beneficiary’s representative. (b) If a therapeutic interchange is reversed, the pharmacy benefits manager or its agent shall: (1) obtain a prescription for and dispense the originally prescribed prescription drug; and (2) charge […]
Section 15-1618 – Accreditation
The Commissioner may consider a pharmacy and therapeutics committee of a pharmacy benefits manager as having met the requirements of §§ 15–1614 and 15–1617 of this part if the pharmacy benefits manager has obtained accreditation from an accrediting organization approved by the Commissioner.
Section 15-1637 – Maintenance of Toll-Free Telephone Number
(a) A pharmacy benefits manager shall maintain a toll–free telephone number Monday through Saturday for prescribers, pharmacies, pharmacists, and beneficiaries to request information regarding a therapeutic interchange. (b) The toll–free telephone number shall be accessible from 8 a.m. until at least 8 p.m. Eastern Standard Time.
Section 15-1619 – Regulations
The Commissioner may adopt regulations to implement this part.
Section 15-1638 – Privacy Standards
All disclosures made under this part shall comply with the privacy standards set forth in State and federal law.
Section 15-1622 – Scope of Part
(a) Except as provided for in subsection (b) of this section, the provisions of §§ 15–1623 and 15–1624 of this subtitle apply only to a pharmacy benefits manager that provides pharmacy benefits management services on behalf of a carrier. (b) The provisions of §§ 15–1623 and 15–1624 of this part do not apply to a pharmacy benefits […]
Section 15-1639 – Policies and Procedures
A pharmacy benefits manager shall establish appropriate policies and procedures to implement the requirements of this part.
Section 15-1606 – Agreements With Unregistered Pharmacy Benefits Managers Prohibited
A carrier may not enter into an agreement with a pharmacy benefits manager that has not registered with the Commissioner.
Section 15-1607 – Denials, Suspensions, Revocations, and Refusals to Renew
(a) Subject to the applicable hearing provisions of Title 2 of this article, the Commissioner may deny a registration to a pharmacy benefits manager applicant or refuse to renew, suspend, or revoke the registration of a pharmacy benefits manager if the pharmacy benefits manager, or an officer, director, or employee of the pharmacy benefits manager: (1) makes […]
Section 15-1608 – Books and Records
A pharmacy benefits manager shall maintain adequate books and records about each purchaser for which the pharmacy benefits manager provides pharmacy benefits management services: (1) in accordance with prudent standards of record keeping; (2) for the duration of the agreement between the pharmacy benefits manager and the purchaser; and (3) for 3 years after the pharmacy benefits manager […]