Code of Maryland Regulations
Title 31 - MARYLAND INSURANCE ADMINISTRATION
Subtitle 10 - HEALTH INSURANCE-GENERAL
Chapter 31.10.48 - Pharmacy Benefits Managers-Informational Filing of Contracts and Amendments
Section 31.10.48.03 - Submission Requirements

Universal Citation: MD Code Reg 31.10.48.03

Current through Register Vol. 51, No. 19, September 20, 2024

A. Pursuant to the requirements of Insurance Article, § 15-1628(b), Annotated Code of Maryland, a PBM shall submit to the Commissioner as an informational filing each participating pharmacy contract form and each amendment to a contract form at least 30 days before the contract form or amendment to the contract form is to become effective.

B. The Commissioner is not required to review the informational filing to evaluate whether a contract form or amendment to a contract form is in violation of Maryland law at the time the informational filing is made.

C. Unless it is disapproved by the Commissioner, a PBM may use a contract form or amendment to a contract form after it has been filed with the Commissioner and 30 days have passed since the filing was acknowledged by the Commissioner in writing as having been received

D. A PBM may not file a contract form or amendment form that has been previously disapproved by the Commissioner.

E. Nothing in this regulation shortens the time period for notice under Insurance Article, § 15-1628(a), Annotated Code of Maryland, which requires a PBM to provide at least 30 working days' notice before any contract change.

F. The filing shall include a cover letter which includes the following:

(1) A list of the contract forms and amendment forms included in the submission; and

(2) A brief description of the purpose of each contract form and amendment form included in the submission.

G. Each page of a contract or amendment shall be identified by a form number which is unique to that form. This number shall be printed in the lower left-hand corner of the first page, and no other number shall appear in close proximity to the form number.

H. A filing made under this chapter shall include a signed certification from a responsible officer of the PBM that, to the best of the officer's knowledge and belief, the contract forms and amendment forms comply with applicable statutes and regulations.

I. A PBM may not file a contract form or amendment form before the PBM has successfully registered as a PBM with the Commissioner.

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