Current as of December 31, 2021 | Updated by FindLaw Staff
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(a) A pharmacy benefits manager or its agent shall cancel and reverse a therapeutic interchange on written or verbal instructions from a prescriber, the beneficiary, or the beneficiary's representative.
(b) If a therapeutic interchange is reversed, the pharmacy benefits manager or its agent shall:
(1) obtain a prescription for and dispense the originally prescribed prescription drug; and
(2) charge the beneficiary no more than one copayment.
(c) If the therapeutic interchange occurred through a mail order pharmacy and a beneficiary will exhaust an existing supply of the originally prescribed prescription drug before a replacement shipment will arrive to the beneficiary, the pharmacy benefits manager or its agent shall arrange for dispensing of an appropriate quantity of replacement prescription drugs at a local community pharmacy at no additional cost to the beneficiary.
(d) A pharmacy benefits manager or its agent may not be required to cancel and reverse a therapeutic interchange if a beneficiary is unwilling to pay a higher copayment or coinsurance associated with the originally prescribed prescription drug.
Cite this article: FindLaw.com - Maryland Code, Insurance § 15-1636 - last updated December 31, 2021 | https://codes.findlaw.com/md/insurance/md-code-insurance-sect-15-1636/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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