§ 15–822.1
Statutes in effect as of October 1, 2026.
Md. Code Ann., Ins. § 15-822.1 (2026)
Title 15. Health Insurance
Subtitle 8. Required Health Insurance Benefits
§ 15–822.1LinkCopy Citation
(a)
(1)
This section applies to:
(i)
insurers and nonprofit health service plans that provide coverage for prescription drugs and devices to individuals or groups under health insurance policies or contracts that are delivered in the State; and
(ii)
health maintenance organizations that provide coverage for prescription drugs and devices to individuals or groups under contracts that are issued or delivered in the State.
(2)
An insurer, a nonprofit health service plan, or a health maintenance organization that provides coverage for prescription drugs and devices through a pharmacy benefits manager is subject to the requirements of this section.
(b)
An entity subject to this section shall limit the amount a covered individual is required to pay in copayments or coinsurance for a covered prescription insulin drug to not more than $30 for a 30–day supply, regardless of the amount or type of insulin needed to fill the covered individual’s prescription.
(c)
An entity subject to this section may set the amount a covered individual is required to pay to an amount that is less than the payment amount limit under subsection (b) of this section.
(d)
A contract between an entity subject to this section, or a pharmacy benefits manager through which the entity provides coverage for prescription drugs and devices, and a pharmacy or the pharmacy’s contracting agent, may not:
(1)
authorize a party to the contract to charge a covered individual an amount that is more than the payment amount limit under subsection (b) of this section;
(2)
require a pharmacy to collect from a covered individual an amount that is more than the payment amount limit under subsection (b) of this section; or
(3)
require a covered individual to pay an amount that is more than the payment amount limit under subsection (b) of this section.