1. A. A therapy management contract shall be signed by the:

   1. (1) Authorized prescriber or authorized prescribers involved in the management of the patient under a prescriber-pharmacist agreement;
   2. (2) Pharmacist or pharmacists involved in the management of the patient under a prescriber-pharmacist agreement; and
   3. (3) Patient receiving care under the therapy management contract.

2. B. A therapy management contract shall contain:

   1. (1) A list of allowable substitutions of chemically dissimilar drugs, if any;

   2. (2) A statement that:

      1. (a) None of the parties involved in the therapy management contract have been:

         1. (i) Coerced into participating in the therapy management contract;
         2. (ii) Given economic incentives, excluding normal reimbursement for services rendered; or
         3. (iii) Involuntarily required to participate in the therapy management contract; and

      2. (b) The pharmacist shall notify the authorized prescriber under the terms of the prescriber-pharmacist agreement if the pharmacist:

         1. (i) Modifies the dose or agent under the therapy management contract; or
         2. (ii) Detects an abnormal result from an assessment activity;

   3. (3) Notice to the patient stating:

      1. (a) That the patient may terminate the therapy management contract at any time; and
      2. (b) The procedure by which the patient may terminate the therapy management contract;
   4. (4) A procedure for periodic review by the authorized prescriber of the drugs modified under the prescriber-pharmacist agreement or changed with the consent of the authorized prescriber;
   5. (5) A reference to the protocol or protocols under which the pharmacist shall act; and
   6. (6) Exceptions or limitations to the protocol or protocols for the specific patient.

Authority: Health Occupations Article, §§12-6A-01 — 12-6A-10, Annotated Code of Maryland

Effective date: December 11, 2003 (30:24 Md. R. 1742)

Chapter revised effective April 15, 2013 (40:7 Md. R. 611)

Regulation .01B amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .02 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .03 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .04 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .05 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .06 amended effective March 28, 2016 (43:6 Md. R. 409)

Regulation .07 amended effective March 28, 2016 (43:6 Md. R. 409)