<?xml version='1.0' encoding='utf-8'?>
<regulation prefix="Regulation" num=".07" citation="COMAR 10.09.60.07" title_num="10" subtitle_num="09" chapter_num="60" heading="Contracts with Prescription Drug Plan Sponsors.">
  <paragraph num="A.">
    <text>The Department may enter into contracts with prescription drug plan sponsors who have been approved by the Centers for Medicare and Medicaid Services to offer Medicare Part D plans in the State.</text>
  </paragraph>
  <paragraph num="B.">
    <text>A prescription drug plan sponsor that enters into a contract with the Department shall agree to perform its obligations in a manner that complies with:</text>
    <paragraph num="(1)">
      <text>Medicare Part D and any federal regulations adopted to implement Medicare Part D;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>The Program;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>The terms and conditions of the contract; and</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Guidance from the Centers for Medicare and Medicaid Services.</text>
    </paragraph>
  </paragraph>
  <paragraph num="C.">
    <text>A contract entered into with the Department shall include provisions that require the prescription drug plan sponsor to:</text>
    <paragraph num="(1)">
      <text>Coordinate with the Program in identifying member enrollees;</text>
    </paragraph>
    <paragraph num="(2)">
      <text>Accept the premium subsidy on behalf of member enrollees;</text>
    </paragraph>
    <paragraph num="(3)">
      <text>Apply the premium subsidy to the member enrollee's total premium costs;</text>
    </paragraph>
    <paragraph num="(4)">
      <text>Separately bill member enrollees for any premium owed in excess of the premium subsidy paid by the Program;</text>
    </paragraph>
    <paragraph num="(5)">
      <text>Account for the subsidies received from the Program;</text>
    </paragraph>
    <paragraph num="(6)">
      <text>Communicate in writing with member enrollees, including notifying member enrollees of their enrollment status;</text>
    </paragraph>
    <paragraph num="(7)">
      <text>Share enrollment data and information with the Department;</text>
    </paragraph>
    <paragraph num="(8)">
      <text>Report data and enrollment information as required by the Department;</text>
    </paragraph>
    <paragraph num="(9)">
      <text>Reconcile Program and member payments with enrollment data; and</text>
    </paragraph>
    <paragraph num="(10)">
      <text>Transmit information to appropriate third-parties, including the Administrator and the Centers for Medicare and Medicaid Services.</text>
    </paragraph>
  </paragraph>
</regulation>