§ 15–1631
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 15-1631 (2026)
Title 15. Health Insurance
Subtitle 16. Pharmacy Benefits Managers
§ 15–1631LinkCopy Citation
Except for an overpayment as defined in § 15–1629(h) of this subtitle, if a claim has been approved by a pharmacy benefits manager through adjudication, the pharmacy benefits manager may not retroactively deny or modify reimbursement to a pharmacy or pharmacist for the approved claim unless:
(1)
the claim was fraudulent;
(2)
the pharmacy or pharmacist had been reimbursed for the claim previously; or
(3)
the services reimbursed were not rendered by the pharmacy or pharmacist.