Current with changes from the 2024 Legislative Session
Section 15-822.1 - Limited copayments(a)(1) This section applies to: (i) insurers and nonprofit health service plans that provide coverage for prescription drugs and devices to individuals or groups under health insurance policies or contracts that are delivered in the State; and(ii) health maintenance organizations that provide coverage for prescription drugs and devices to individuals or groups under contracts that are issued or delivered in the State.(2) An insurer, a nonprofit health service plan, or a health maintenance organization that provides coverage for prescription drugs and devices through a pharmacy benefits manager is subject to the requirements of this section.(b) An entity subject to this section shall limit the amount a covered individual is required to pay in copayments or coinsurance for a covered prescription insulin drug to not more than $30 for a 30-day supply, regardless of the amount or type of insulin needed to fill the covered individual's prescription.(c) An entity subject to this section may set the amount a covered individual is required to pay to an amount that is less than the payment amount limit under subsection (b) of this section.(d) A contract between an entity subject to this section, or a pharmacy benefits manager through which the entity provides coverage for prescription drugs and devices, and a pharmacy or the pharmacy's contracting agent, may not:(1) authorize a party to the contract to charge a covered individual an amount that is more than the payment amount limit under subsection (b) of this section;(2) require a pharmacy to collect from a covered individual an amount that is more than the payment amount limit under subsection (b) of this section; or(3) require a covered individual to pay an amount that is more than the payment amount limit under subsection (b) of this section.Added by 2022 Md. Laws, Ch. 405, Sec. 1, eff. 1/1/2023.