# Insurance (GIN)

## Title 15. Health Insurance

### Subtitle 16. Pharmacy Benefits Managers

#### Section 15-1631

Except for an overpayment as defined in Sec. 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.

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Md. Code Ann., Ins. (as displayed at mgaleg.maryland.gov, October 16, 2026)