Contracts With Pharmacies and Pharmacists; Audits

  1. Law
  2. Maryland Code
  3. Insurance
  4. Health Insurance
  5. Pharmacy Benefits Managers
  6. Contracts With Pharmacies and Pharmacists; Audits

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Section
15-1628

Required disclosures by pharmacy benefits manager; filing requirements for contract or amendment to contract.

Section
15-1628.1

Maximum allowable cost pricing between pharmacy benefits manager and contracted pharmacy.

Section
15-1628.2

Disputes regarding cost pricing and reimbursement.

Section
15-1628.3

Fee or performance-based reimbursement related to claim adjudication.

Section
15-1629

Audits by pharmacy benefits manager

Section
15-1630

Internal review process

Section
15-1631

Retroactive denial or modification of reimbursement for approved claim