<?xml version='1.0' encoding='utf-8'?>
<section article="gin" article_name="Insurance" number="15-1631" title_number="15" title_name="Health Insurance" subtitle_number="16" subtitle_name="Pharmacy Benefits Managers">
  <text>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:</text>
  <level label="1">
    <text>the claim was fraudulent;</text>
  </level>
  <level label="2">
    <text>the pharmacy or pharmacist had been reimbursed for the claim previously; or</text>
  </level>
  <level label="3">
    <text>the services reimbursed were not rendered by the pharmacy or pharmacist.</text>
  </level>
</section>
