Maryland Code § IN-15-118

Section IN-15-118
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(a) (1) In this section the following words have the meanings indicated.
(2) "Health care service" means a health or medical care procedure
or service rendered by a provider that:
(i) provides testing, diagnosis, or treatment of human disease
or dysfunction; or
(ii) dispenses drugs, medical devices, medical appliances, or
medical goods for the treatment of human disease or dysfunction.
(3) "Provider" means a physician, hospital, or other person that is
licensed or otherwise authorized to provide health care services.
(b) This section applies to:
(1) insurers and nonprofit health service plans that provide coverage
for health care services to individuals or groups on an expense-incurred basis under
health insurance policies or contracts that are issued or delivered in the State; and
(2) health maintenance organizations that provide coverage for
health care services to individuals or groups under contracts that are issued or
delivered in the State.
(c) If an entity subject to this section negotiates and enters into a contract
with providers to render health care services to insureds, subscribers, or members at
alternative rates of payment, and coinsurance payments are to be based on a
percentage of the fee for health care services rendered by a provider, the entity shall
calculate the amount of the coinsurance payment to be paid by the insured,
subscriber, or member exclusively from the negotiated alternative rate for the health
care service rendered.
(d) An entity subject to this section may not charge or collect from an
insured, a subscriber, or a member a coinsurance payment amount that is greater
than the amount calculated under subsection (c) of this section.
§15-118.1. NOT IN EFFECT

** TAKES EFFECT JANUARY 1, 2026 PER CHAPTER 692 OF 2025 **
// EFFECTIVE UNTIL JULY 1, 2029 PER CHAPTER 692 OF 2025 //
(a) (1) This section applies to:
(i) insurers and nonprofit health service plans that provide
hospital, medical, or surgical benefits to individuals or groups on an expense-
incurred basis under health insurance policies or contracts that are issued or
delivered in the State; and
(ii) health maintenance organizations that provide hospital,
medical, or surgical benefits 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 through a
pharmacy benefits manager is subject to the requirements of this section.
(b) (1) Subject to paragraph (2) of this subsection, when calculating an
insured's or enrollee's contribution to the insured's or enrollee's coinsurance,
copayment, deductible, or out-of-pocket maximum under the insured's or enrollee's
health benefit plan, an entity subject to this section shall include any discount,
financial assistance payment, product voucher, or other out-of-pocket expense made
by or on behalf of the insured or enrollee for a prescription drug:
(i) that is covered under the insured's or enrollee's health
benefit plan; and
(ii) 1. that does not have an AB-rated generic equivalent
drug or an interchangeable biological product preferred under the health benefit
plan's formulary; or
2. A. that has an AB-rated generic equivalent drug
or an interchangeable biological product preferred under the health benefit plan's
formulary; and
B. for which the insured or enrollee originally obtained
coverage through prior authorization, a step therapy protocol, or the exception or
appeal process of the entity subject to this section.
(2) If an insured or enrollee is covered under a high-deductible
health plan, as defined in 26 U.S.C. § 223, this subsection does not apply to the
deductible requirement of the high-deductible health plan.

(c) (1) Except as provided in paragraph (3) of this subsection, a person
that provides a discount, financial assistance payment, product voucher, or other out-
of-pocket expense made by or on behalf of the insured or enrollee that is used in the
calculation of the insured's or enrollee's contribution to the insured's or enrollee's
coinsurance, copayment, deductible, or out-of-pocket maximum shall, within 7 days
after the acceptance of the discount, financial assistance payment, product voucher,
or other out-of-pocket expense, notify the insured or enrollee of:
(i) the maximum dollar amount of the discount, financial
assistance payment, product voucher, or other out-of-pocket expense; and
(ii) the expiration date for the discount, financial assistance
payment, product voucher, or other out-of-pocket expense.
(2) A violation of paragraph (1) of this subsection is a violation of the
Consumer Protection Act.
(3) This subsection does not apply to a charitable organization that
provides a discount, financial assistance payment, product voucher, or other out-of-
pocket expense to an insured or enrollee.
(d) (1) Subject to paragraph (2) of this subsection, an entity subject to
this section may not directly or indirectly set, alter, implement, or condition the terms
of health benefit plan coverage, including the benefit design, based in whole or in part
on information about the availability or amount of financial or product assistance
available for a prescription drug.
(2) Paragraph (1) of this subsection may not be construed to prohibit
an entity subject to this section from using rebates in the design of prescription drug
coverage or benefits.

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