2018 Maryland Code
Insurance
Title 15 - Health Insurance
Subtitle 16 - Pharmacy Benefits Managers
Part III - Pharmacy and Therapeutics Committees
§ 15-1617. Required policies, procedures, and processes.
- A pharmacy benefits manager shall ensure that its pharmacy and therapeutics committee has:
(1) policies and procedures, including disclosure requirements, to address potential conflicts of interest that members of the pharmacy and therapeutics committee may have with developers or manufacturers of prescription drugs;
(2) a process to evaluate medical and scientific evidence concerning the safety and effectiveness of prescription drugs, including available comparative information on clinically similar prescription drugs, when deciding what prescription drugs to recommend to include on a formulary;
(3) a process to evaluate medical and scientific evidence concerning the safety and effectiveness of prescription drugs when recommending utilization review requirements, dose restrictions, and step therapy requirements; and
(4) a process to enable the pharmacy and therapeutics committee to consider the need to recommend a formulary change to a purchaser in a timely manner but at least annually.
