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Ch. 28 2006 LAWS OF MARYLAND
(iii) SUBJECT TO ITEM (V) OF THIS PARAGRAPH, the Prescription
Drug Benefit Plan [shall offer a voluntary mail order option and the Prescription
Drug Benefit Plan] may charge enrollees the following co-payments for prescription
drugs:
1. $5 for generic drugs;
2. $15 for preferred drugs on the State formulary; and
3. $25 for drugs that are not preferred drugs on the State
formulary;
(iv) SUBJECT TO ITEM (V) OF THIS PARAGRAPH, the Prescription
Drug Benefit Plan may charge a co-payment as provided in item (iii) of this
[subsection] PARAGRAPH for each [45 day] 45-DAY prescription;
(V) THE PRESCRIPTION DRUG BENEFIT PLAN:
1. SHALL OFFER A VOLUNTARY MAIL ORDER OPTION TO
ENROLLEES; AND
2. MAY CHARGE ENROLLEES A CO-PAYMENT NOT
EXCEEDING $20 FOR EACH 90-DAY PRESCRIPTION FILLED THROUGH THE
VOLUNTARY MAIL ORDER OPTION;
[(v)] (VI) for each fiscal year, the total amount of co-payments
charged the employee or retiree and their dependents as provided in [item] ITEMS
(iii) AND (V) of this [subsection] PARAGRAPH may not exceed $700; and
[(vi)] (VII) the Prescription Drug Benefit Plan may include the
following programmatic changes:
1. implementation of a step therapy program to assure that
lower cost alternatives are used first;
2. changes in the pharmacy network;
3. limitations on the first prescription for a maintenance
drug;
4. limitations on the quantity of drugs dispensed to reduce
inappropriate or excessive drug usage;
5. requirements for prior authorization of drugs to ensure
that they are medically necessary; and
6. implementation of a drug utilization review program.
SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect
July 1, 2006.
Approved April 6, 2006.
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