1. 2018 Policy and Legislative Update February 18, 2018
Aliyah N. Horton, CAE
Executive Director
Maryland Pharmacists Association

2. Presentation Overview
Policy Highlights
Pharmacy-related legislation
Legislative and regulatory resources

3. 438th Session – Maryland General Assembly
90 days
Nearly 3,000 bills & resolutions
ELECTION YEAR!
Fun Fact!

4. Expanded Medication Administration
Legislation under development
Proposed legislation to expand pharmacists scope to administer a broader range of medications
Moves beyond “self-administered” drugs
Modifies the statues related to pharmacist immunizations to include injectable medications and biologicals
Under a written order or treatment guidelines established by a prescriber

5. Removing Pharmacist “Gag Order”
Legislation under development.
PBM may not prohibit a pharmacy or pharmacist from :
Providing or discussing with a patient with information regarding the cash price for a prescription drug or the amount of the cost share for which the patient is responsible; or
if a more affordable drug is available, selling the more affordable alternative.

6. Contracts With and Reimbursement of Pharmacists
Based on NCPA Model Language
MAC LIST
Address PBM requirements with respect to multi-source generic pricing updates to pharmacies.
Transparency in the methodology and sources for determining the MAC list and all MAC lists used by the PBM for their contract with a pharmacy
Time line for updating and disclosing the list as well as eliminating drugs that do not meet the requirements
Dispensing fees and other professional fees may not be included in calculations
List must be updated every seven days
Disclosure requirements if non-parity in MAC lists for medications dispensed in retail vs. mail-order
Disclosures to plan sponsor if MAC lists are different between billing the plan sponsor and reimbursing the pharmacy

7. Contracts With and Reimbursement of Pharmacists (contd.)
Standards for Pharmacy Appeals
Requires an appeal response within seven days
Specific guidance on how to file an appeal publicly available on a website a
Denied appeals may be subject to review by the MIA
MAC adjustments must be made for all pharmacies in network from effective date of the original claim
Automatically apply retroactive reimbursements in next payment cycle
Licensing and Enforcement
Empowers MIA with new licensing and enforcement provisions that includes all PBM work on behalf of a health benefit plan, state agency, insurer, Medicaid MCO or third-party payors.

8. Electronic Prescriptions Cost Saving Act
Requires dispensers to submit prescription information to the state health information exchange
Prohibits Maryland Health Care Commission from imposing fees or assessments
MHCC to adopt regulations to specify :
specific prescription information to be required for submission
time frame for submitting prescription information
who may access the prescription information after it is submitted
permissible uses of prescription information; and
permission information submission requirements that align with data submission requirements of the PDMP.

9. Medicinal Cannabis Commission Reform
Bills introduced to reform cannabis commission to address issues related to:
Reduce size of commission
Commissioner Transparency (financial and other disclosures)
Diversity in licensees and contracts approved by the commission
Compassionate use fund
MPhA strongly believes a medication and dispensing expert should be on the commission that has an oversight and regulatory role for the industry.

10. Other Pending Hot Topics
E-Prescribing
90-day fill
Specialty Drugs
DIR Fees

11. Questions

12. Legislative and Regulatory Resources
Maryland General Assembly
Maryland Code of Regulations
Fader’s Pharmacy Law Book: Pharmacy Laws and Regulations for the State of Maryland
Resources

13. Maryland Pharmacists Association
Thank you
Maryland Pharmacists Association
Facebook: /MarylandPharmacistsAssociati on
Website:
Aliyah N. Horton, CAE
Executive Director
Phone: