Ch. 440

LAWS OF MARYLAND

changes as that percentage is reported in the Federal Register
pursuant to 42 USC 415 (i)(2)(d) but not to exceed 8 percent; or

2. The dollar amount by which the medical
assistance income schedules are increased by the State] IN
ACCORDANCE WITH THE UPDATE OF POVERTY INCOME GUIDELINES ISSUED
ANNUALLY BY THE UNITED STATES DEPARTMENT OF HEALTH AND HUMAN
SERVICES.

(b)  (1) The Maryland Pharmacy Assistance Program shall
reimburse providers for those kinds of items and services that
are covered by the pharmacy program of the Maryland Medical
Assistance Program. HOWEVER, FOR ANY DRUG ON THE PROGRAM'S
INTERCHANGEABLE DRUG LIST, THE PROGRAM SHALL REIMBURSE PROVIDERS
IN AN AMOUNT NOT MORE THAN IT WOULD REIMBURSE FOR THE DRUG'S
GENERIC EQUIVALENT, UNLESS THE INDIVIDUAL'S PHYSICIAN STATES THAT
THE GENERIC EQUIVALENT IS NOT MEDICALLY APPROPRIATE FOR THAT
PATIENT, IN HIS OR HER OWN HANDWRITING, ON THE FACE OF THE
PRESCRIPTION, THAT A SPECIFIC BRAND IS "MEDICALLY NECESSARY" FOR
THE PARTICULAR PATIENT.

(2) The reimbursement shall be up to the amount paid
for the same items or services under the pharmacy program of the
Maryland Medical Assistance Program and subject to a copayment of
not more than $1 for each covered item or service.

(c)  (1) The Secretary shall adopt rules and regulations
that authorize the denial, restriction, or termination of
eligibility for recipients who have abused benefits under the
Maryland Pharmacy Assistance Program.

(2) AS A CONDITION OF PARTICIPATION, THE DEPARTMENT
MAY REQUIRE MARYLAND PHARMACY ASSISTANCE PROGRAM PARTICIPANTS TO
APPLY FOR ELIGIBILITY IN THE MARYLAND MEDICAL ASSISTANCE PROGRAM
WITHIN 60 DAYS OF NOTIFICATION TO DO SO BY THE DEPARTMENT.

(2) (3) The rules and regulations shall require that
the recipient be given notice and an opportunity for a hearing
before eligibility may be denied, restricted, or terminated under
this subsection.

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall
take effect July 1, 1989.

Approved May 19, 1989.

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