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 15-1623 – Requirements Before Entering Into Contract
(a) Before entering into a contract with a purchaser, a pharmacy benefits manager: (1) as applicable, shall inform the purchaser that the pharmacy benefits manager may: (i) solicit and receive manufacturer payments; (ii) pass through or retain the manufacturer payments depending on the contract terms with a purchaser; (iii) sell aggregate utilization information; and (iv) share aggregate utilization information with other […]
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.