Maryland Code § HG-19-713.6

Section HG-19-713.6
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(a) (1) In this section the following words have the meanings indicated.
(2) "Documented informed consent" means:
(i) A written consent form signed by a patient; or
(ii) Verbal or otherwise communicated consent signified by a
notation in a patient's electronic medical record maintained by a group model health
maintenance organization.
(3) "Drug therapy management" means treatment of a patient using
drug therapy, laboratory tests, or medical devices under conditions or limitations set
forth in a protocol specified in a physician-pharmacist agreement for the purpose of
improving patient outcome.
(4) "Group model health maintenance organization" means a health
maintenance organization that:
(i) Contracts with one multispecialty group of physicians who
are employed by and shareholders of the multispecialty group; and
(ii) Provides and arranges for the provision of physician
services to patients at medical facilities operated by the health maintenance
organization.
(5) "Licensed pharmacist" means an individual who is licensed to
practice pharmacy under Title 12 of the Health Occupations Article.
(6) "Licensed physician" means an individual who is licensed to
practice medicine under Title 14 of the Health Occupations Article.
(7) "Patient" means:
(i) A patient who is a member of a group model health
maintenance organization; or
(ii) An individual to whom the group model health
maintenance organization is contractually or legally obligated to provide, or arrange
to provide, health care services.

(8) "Physician-pharmacist agreement" means an agreement
between a licensed physician and a licensed pharmacist that is disease-state specific
and specifies the protocols that may be used.
(9) "Protocol" means a course of treatment predetermined by the
licensed physician and licensed pharmacist according to generally accepted medical
practice for the proper completion of a particular therapeutic or diagnostic
intervention.
(b) (1) In a group model health maintenance organization, a licensed
physician and a licensed pharmacist who wish to provide drug therapy management
to patients shall have a physician-pharmacist agreement.
(2) Drug therapy management shall be provided under this section
only:
(i) In accordance with a physician-pharmacist agreement;
and
(ii) Through the internal pharmacy operations of the group
model health maintenance organization.
(3) A licensed physician who has entered into a physician-
pharmacist agreement shall submit to the State Board of Physicians a copy of the
physician-pharmacist agreement and any subsequent modifications made to the
physician-pharmacist agreement or the protocols specified in the physician-
pharmacist agreement.
(4) A licensed pharmacist who has entered into a physician-
pharmacist agreement shall submit to the State Board of Pharmacy a copy of the
physician-pharmacist agreement and any subsequent modifications made to the
physician-pharmacist agreement or the protocols specified in the physician-
pharmacist agreement.
(c) A licensed pharmacist is authorized to enter into a physician-
pharmacist agreement if the licensed pharmacist:
(1) Has a Doctor of Pharmacy degree or equivalent training as
established in regulations adopted by the State Board of Pharmacy;
(2) Is approved by the State Board of Pharmacy to enter into a
physician-pharmacist agreement with a licensed physician; and

(3) Meets any other requirements established by regulation by the
State Board of Pharmacy.
(d) A physician-pharmacist agreement shall prohibit the substitution of a
chemically dissimilar drug product by the pharmacist for the product prescribed by
the physician, unless permitted in the protocol specified in the physician-pharmacist
agreement.
(e) A patient may decline to participate or withdraw from participating in
drug therapy management in a group model health maintenance organization at any
time.
(f) A licensed physician or licensed pharmacist or both shall inform a
patient:
(1) Regarding the procedures that will be utilized for drug therapy
management under the associated protocols;
(2) That the patient may decline to participate or withdraw from
participating in the drug therapy management at any time; and
(3) That neither the physician nor the pharmacist has been coerced,
given economic incentives, excluding normal reimbursement for services rendered, or
involuntarily required to participate.
(g) A licensed physician or a licensed pharmacist or both shall obtain
documented informed consent from a patient after disclosing the information
required to be disclosed under subsection (f) of this section.

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