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Session Laws, 2005
Volume 752, Page 2424   View pdf image
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2005 LAWS OF MARYLAND
Ch. 444
(II) (III) 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; (III) (IV) THE PRESCRIPTION DRUG BENEFIT PLAN MAY CHARGE A
CO-PAYMENT AS PROVIDED IN ITEM (II) (III) OF THIS SUBSECTION FOR EACH 45 DAY
PRESCRIPTION; (IV) (V) FOR EACH FISCAL YEAR. THE TOTAL AMOUNT OF
CO-PAYMENTS CHARGED THE EMPLOYEE OR RETIREE AND THEIR DEPENDENTS AS
PROVIDED IN ITEM (II) (III) OF THIS SUBSECTION MAY NOT EXCEED $700; AND (VI) 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. 2-503. (a) The Secretary shall: (1) adopt regulations for the administration of the Program; (2) ensure that the Program complies with all federal and State laws
governing employee benefit plans; and (3) each year, recommend to the Governor the State share of the costs of
the Program.
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Session Laws, 2005
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