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<section article="ghg" article_name="Health - General" number="19-713.6" title_number="19" title_name="Health Care Facilities" subtitle_number="7" subtitle_name="Health Maintenance Organizations">
  <level label="a">
    <level label="1">
      <text>In this section the following words have the meanings indicated.</text>
    </level>
    <level label="2">
      <text>“Documented informed consent” means:</text>
      <level label="i">
        <text>A written consent form signed by a patient; or</text>
      </level>
      <level label="ii">
        <text>Verbal or otherwise communicated consent signified by a notation in a patient’s electronic medical record maintained by a group model health maintenance organization.</text>
      </level>
    </level>
    <level label="3">
      <text>“Drug therapy management” means treatment of a patient using drug therapy, laboratory tests, or medical devices under conditions or limitations set forth in a protocol specified in a physician–pharmacist agreement for the purpose of improving patient outcome.</text>
    </level>
    <level label="4">
      <text>“Group model health maintenance organization” means a health maintenance organization that:</text>
      <level label="i">
        <text>Contracts with one multispecialty group of physicians who are employed by and shareholders of the multispecialty group; and</text>
      </level>
      <level label="ii">
        <text>Provides and arranges for the provision of physician services to patients at medical facilities operated by the health maintenance organization.</text>
      </level>
    </level>
    <level label="5">
      <text>“Licensed pharmacist” means an individual who is licensed to practice pharmacy under Title 12 of the Health Occupations Article.</text>
    </level>
    <level label="6">
      <text>“Licensed physician” means an individual who is licensed to practice medicine under Title 14 of the Health Occupations Article.</text>
    </level>
    <level label="7">
      <text>“Patient” means:</text>
      <level label="i">
        <text>A patient who is a member of a group model health maintenance organization; or</text>
      </level>
      <level label="ii">
        <text>An individual to whom the group model health maintenance organization is contractually or legally obligated to provide, or arrange to provide, health care services.</text>
      </level>
    </level>
    <level label="8">
      <text>“Physician–pharmacist agreement” means an agreement between a licensed physician and a licensed pharmacist that is disease–state specific and specifies the protocols that may be used.</text>
    </level>
    <level label="9">
      <text>“Protocol” means a course of treatment predetermined by the licensed physician and licensed pharmacist according to generally accepted medical practice for the proper completion of a particular therapeutic or diagnostic intervention.</text>
    </level>
  </level>
  <level label="b">
    <level label="1">
      <text>In a group model health maintenance organization, a licensed physician and a licensed pharmacist who wish to provide drug therapy management to patients shall have a physician–pharmacist agreement.</text>
    </level>
    <level label="2">
      <text>Drug therapy management shall be provided under this section only:</text>
      <level label="i">
        <text>In accordance with a physician–pharmacist agreement; and</text>
      </level>
      <level label="ii">
        <text>Through the internal pharmacy operations of the group model health maintenance organization.</text>
      </level>
    </level>
    <level label="3">
      <text>A licensed physician who has entered into a physician–pharmacist agreement shall submit to the State Board of Physicians a copy of the physician–pharmacist agreement and any subsequent modifications made to the physician–pharmacist agreement or the protocols specified in the physician–pharmacist agreement.</text>
    </level>
    <level label="4">
      <text>A licensed pharmacist who has entered into a physician–pharmacist agreement shall submit to the State Board of Pharmacy a copy of the physician–pharmacist agreement and any subsequent modifications made to the physician–pharmacist agreement or the protocols specified in the physician–pharmacist agreement.</text>
    </level>
  </level>
  <level label="c">
    <text>A licensed pharmacist is authorized to enter into a physician–pharmacist agreement if the licensed pharmacist:</text>
    <level label="1">
      <text>Has a Doctor of Pharmacy degree or equivalent training as established in regulations adopted by the State Board of Pharmacy;</text>
    </level>
    <level label="2">
      <text>Is approved by the State Board of Pharmacy to enter into a physician–pharmacist agreement with a licensed physician; and</text>
    </level>
    <level label="3">
      <text>Meets any other requirements established by regulation by the State Board of Pharmacy.</text>
    </level>
  </level>
  <level label="d">
    <text>A physician–pharmacist agreement shall prohibit the substitution of a chemically dissimilar drug product by the pharmacist for the product prescribed by the physician, unless permitted in the protocol specified in the physician–pharmacist agreement.</text>
  </level>
  <level label="e">
    <text>A patient may decline to participate or withdraw from participating in drug therapy management in a group model health maintenance organization at any time.</text>
  </level>
  <level label="f">
    <text>A licensed physician or licensed pharmacist or both shall inform a patient:</text>
    <level label="1">
      <text>Regarding the procedures that will be utilized for drug therapy management under the associated protocols;</text>
    </level>
    <level label="2">
      <text>That the patient may decline to participate or withdraw from participating in the drug therapy management at any time; and</text>
    </level>
    <level label="3">
      <text>That neither the physician nor the pharmacist has been coerced, given economic incentives, excluding normal reimbursement for services rendered, or involuntarily required to participate.</text>
    </level>
  </level>
  <level label="g">
    <text>A licensed physician or a licensed pharmacist or both shall obtain documented informed consent from a patient after disclosing the information required to be disclosed under subsection (f) of this section.</text>
  </level>
</section>
