1. A. This chapter applies to a payor that:

   1. (1) Requires preauthorization for health care services; and
   2. (2) Is required to report to the Maryland Health Care Commission on its attainment and plans for attainment of certain preauthorization benchmarks.

2. B. This chapter does not apply to a pharmacy benefits manager that only provides services for:

   1. (1) Workers’ compensation claims pursuant to Labor and Employment Article, Title 9, Annotated Code of Maryland; or
   2. (2) Personal injury protection claims pursuant to Insurance Article, Title 19, Annotated Code of Maryland..

Authority: Health-General Article, §§19-101 and 19-108.2, Annotated Code of Maryland

Effective date: February 18, 2013 (40:3 Md. R. 218)

Regulation .01 amended effective January 9, 2023 (49:27 Md. R. 1110)

Regulation .02B amended effective October 12, 2015 (42:20 Md. R. 1265); January 9, 2023 (49:27 Md. R. 1110)

Regulation .03 amended effective October 12, 2015 (42:20 Md. R. 1265); January 9, 2023 (49:27 Md. R. 1110)

Regulation .04 amended effective October 12, 2015 (42:20 Md. R. 1265); January 9, 2023 (49:27 Md. R. 1110)

Regulation .05 amended effective October 12, 2015 (42:20 Md. R. 1265); January 9, 2023 (49:27 Md. R. 1110)