Maryland HB1384 establishes a State Pharmacy Benefits Manager for the Maryland Medical Assistance Program.

Maryland HB1384 mandates the Department of Health to contract with a single third-party administrator as the State Pharmacy Benefits Manager for the Maryland Medical Assistance Program by July 1, 2028. Managed care contracts entered into or renewed after this date must require managed care organizations to use this State pharmacy benefits manager for administering pharmacy benefits. The contract with the State pharmacy benefits manager must use a common formulary, reimbursement methodologies, and dispensing fees negotiated by the Department.

Maryland HB1384 establishes a State Pharmacy Benefits Manager for the Maryland Medical Assistance Program.

Maryland HB1384 mandates the Department of Health to contract with a single third-party administrator as the State Pharmacy Benefits Manager for the Maryland Medical Assistance Program by July 1, 2028. Managed care contracts entered into or renewed after this date must require managed care organizations to use this State pharmacy benefits manager for administering pharmacy benefits. The contract with the State pharmacy benefits manager must use a common formulary, reimbursement methodologies, and dispensing fees negotiated by the Department.