Md. Code Ann., Ins. § 15-850
Prior authorization requirement for an opioid antagonist
Effective Jan 1, 2018Added by Acts 2017, c. 571, § 4, eff. Jan. 1, 2018; Acts 2017, c. 572, § 4, eff. Jan. 1, 2018.State of Maryland
(a) In this section, “opioid antagonist” means:
- (1) naloxone hydrochloride; or
- (2) any other similarly acting and equally safe drug approved by the federal Food and Drug Administration for the treatment of a drug overdose.
(b)
(1) This section applies to:
- (i) insurers and nonprofit health service plans that provide coverage for prescription drugs under individual, group, or blanket health insurance policies or contracts that are issued or delivered in the State; and
- (ii) health maintenance organizations that provide coverage for prescription drugs under individual or group contracts that are issued or delivered in the State.
- (2) An insurer, a nonprofit health service plan, or a health maintenance organization that provides coverage for prescription drugs through a pharmacy benefits manager is subject to the requirements of this section.
- (c) An entity subject to this section that includes on its formulary an opioid antagonist may apply a prior authorization requirement for an opioid antagonist only if the entity provides coverage for at least one formulation of the opioid antagonist without a prior authorization requirement.
Added by Acts 2017, c. 571, § 4, eff. Jan. 1, 2018; Acts 2017, c. 572, § 4, eff. Jan. 1, 2018.