PARRIS N. GLENDENING, Governor

Ch. 36

(2) FOR 3 YEARS AFTER THE ADMINISTRATOR CEASES TO ADMINISTER
THE PLAN:

(I)       SHALL RETAIN THE BOOKS AND RECORDS ABOUT THE PLAN;
AND

(II)     SHALL PROVIDE ACCESS TO THE PLAN SPONSOR AND INSURER
AS PROVIDED UNDER SUBSECTION (B) OF THIS SECTION.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, § 687(c).

In subsections (a)(2) and (b) of this section, the reference to the agreement
"required by § 8-311 of this subtitle" is added for clarity.

Defined terms: "Administrator" § 8-301
"Insurer" § 1-101
"Plan" § 8-301
"Plan sponsor" § 8-301

8-313. NOTICE TO PHARMACIES OF CHANGE IN PHARMACEUTICAL BENEFITS.

(A)     REQUIRED.

AT LEAST 30 DAYS BEFORE THE CHANGE IS EFFECTIVE, AN ADMINISTRATOR
OF A PLAN THAT PROVIDES PHARMACEUTICAL BENEFITS SHALL NOTIFY IN
WRITING ALL PHARMACIES UNDER CONTRACT WITH THE PLAN OF ANY OF THE
FOLLOWING CHANGES IN THE PHARMACEUTICAL BENEFIT PROGRAM RULES OR
REQUIREMENTS:

(1)      EXCLUSION OF COVERAGE FOR CLASSES OF DRUGS AS SPECIFIED
BY CONTRACT;

(2)      CHANGES IN PRIOR OR PREAUTHORIZATION PROCEDURES; OR

(3)      SELECTION OF NEW PRESCRIPTION CLAIMS PROCESSORS.

(B)     FAILURE TO PROVIDE NOTICE.

AN ADMINISTRATOR THAT FAILS TO PROVIDE ADVANCE NOTICE UNDER
SUBSECTION (A) OF THIS SECTION SHALL HONOR AND PAY IN FULL, FOR 30 DAYS
AFTER THE POSTMARKED DATE OF THE NOTICE, ANY CLAIM UNDER THE PROGRAM
RULES OR REQUIREMENTS THAT EXISTED BEFORE THE CHANGE.

REVISOR'S NOTE: This section is new language derived without substantive
change from former Art. 48A, § 697.

Defined terms: "Administrator" § 8-301
"Plan" § 8-301

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