Maryland Statutes
Subtitle 7 - Health Maintenance Organizations
Section 19-713.6 - Drug Therapy Management

(a)    (1)    In this section the following words have the meanings indicated.
        (2)    “Documented informed consent” means:
            (i)    A written consent form signed by a patient; or
            (ii)    Verbal or otherwise communicated consent signified by a notation in a patient’s electronic medical record maintained by a group model health maintenance organization.
        (3)    “Drug therapy management” means treatment of a patient using drug therapy, laboratory tests, or medical devices under conditions or limitations set forth in a protocol specified in a physician–pharmacist agreement for the purpose of improving patient outcome.
        (4)    “Group model health maintenance organization” means a health maintenance organization that:
            (i)    Contracts with one multispecialty group of physicians who are employed by and shareholders of the multispecialty group; and
            (ii)    Provides and arranges for the provision of physician services to patients at medical facilities operated by the health maintenance organization.
        (5)    “Licensed pharmacist” means an individual who is licensed to practice pharmacy under Title 12 of the Health Occupations Article.
        (6)    “Licensed physician” means an individual who is licensed to practice medicine under Title 14 of the Health Occupations Article.
        (7)    “Patient” means:
            (i)    A patient who is a member of a group model health maintenance organization; or
            (ii)    An individual to whom the group model health maintenance organization is contractually or legally obligated to provide, or arrange to provide, health care services.
        (8)    “Physician–pharmacist agreement” means an agreement between a licensed physician and a licensed pharmacist that is disease–state specific and specifies the protocols that may be used.
        (9)    “Protocol” means a course of treatment predetermined by the licensed physician and licensed pharmacist according to generally accepted medical practice for the proper completion of a particular therapeutic or diagnostic intervention.
    (b)    (1)    In a group model health maintenance organization, a licensed physician and a licensed pharmacist who wish to provide drug therapy management to patients shall have a physician–pharmacist agreement.
        (2)    Drug therapy management shall be provided under this section only:
            (i)    In accordance with a physician–pharmacist agreement; and
            (ii)    Through the internal pharmacy operations of the group model health maintenance organization.
        (3)    A licensed physician who has entered into a physician–pharmacist agreement shall submit to the State Board of Physicians a copy of the physician–pharmacist agreement and any subsequent modifications made to the physician–pharmacist agreement or the protocols specified in the physician–pharmacist agreement.
        (4)    A licensed pharmacist who has entered into a physician–pharmacist agreement shall submit to the State Board of Pharmacy a copy of the physician–pharmacist agreement and any subsequent modifications made to the physician–pharmacist agreement or the protocols specified in the physician–pharmacist agreement.
    (c)    A licensed pharmacist is authorized to enter into a physician–pharmacist agreement if the licensed pharmacist:
        (1)    Has a Doctor of Pharmacy degree or equivalent training as established in regulations adopted by the State Board of Pharmacy;
        (2)    Is approved by the State Board of Pharmacy to enter into a physician–pharmacist agreement with a licensed physician; and
        (3)    Meets any other requirements established by regulation by the State Board of Pharmacy.
    (d)    A physician–pharmacist agreement shall prohibit the substitution of a chemically dissimilar drug product by the pharmacist for the product prescribed by the physician, unless permitted in the protocol specified in the physician–pharmacist agreement.
    (e)    A patient may decline to participate or withdraw from participating in drug therapy management in a group model health maintenance organization at any time.
    (f)    A licensed physician or licensed pharmacist or both shall inform a patient:
        (1)    Regarding the procedures that will be utilized for drug therapy management under the associated protocols;
        (2)    That the patient may decline to participate or withdraw from participating in the drug therapy management at any time; and
        (3)    That neither the physician nor the pharmacist has been coerced, given economic incentives, excluding normal reimbursement for services rendered, or involuntarily required to participate.
    (g)    A licensed physician or a licensed pharmacist or both shall obtain documented informed consent from a patient after disclosing the information required to be disclosed under subsection (f) of this section.

Structure Maryland Statutes

Maryland Statutes

Health - General

Title 19 - Health Care Facilities

Subtitle 7 - Health Maintenance Organizations

Section 19-701 - Definitions

Section 19-702 - Declaration of Intent and Policy

Section 19-703 - Scope of Subtitle

Section 19-704 - Corporate Practice of Medicine

Section 19-705 - Rules and Regulations

Section 19-705.1 - Standards of Quality of Care

Section 19-705.2 - Complaints of Members and Subscribers

Section 19-705.3 - Centers for Disease Control and Prevention's Guidelines on Universal Precautions

Section 19-705.4 - Limitations on Covered Services and Visits

Section 19-705.5 - Coverage for Inherited Metabolic Disease

Section 19-705.6 - Emergency Services

Section 19-705.7 - Toll-Free Telephone Access

Section 19-705.8 - Health Maintenance Organization Quality Assurance Unit

Section 19-706 - Regulation; Applicability of Other Laws

Section 19-706.1 - Rehabilitation or Liquidation of Health Maintenance Organizations

Section 19-707 - Authorization to Operate

Section 19-708 - Applications for Certificates to Operate

Section 19-709 - Initial Fees

Section 19-710 - Basic Requirements to Operate as a Health Maintenance Organization

Section 19-710.1 - Payment to Health Care Provider Not Under Written Contract

Section 19-710.2 - Point-of-Service Option

Section 19-711 - Issuance of Certificate of Authority; Merger, Consolidation, etc., With Domestic Health Maintenance Organization

Section 19-711.3 - Merger, Consolidation, or Acquisition of Health Maintenance Organization; Financing Money

Section 19-712 - Powers and Authority of Health Maintenance Organization

Section 19-712.2 - Notice to Pharmacies of Change in Pharmaceutical Benefits

Section 19-712.4 - Prohibited Referrals

Section 19-712.5 - Reimbursement for Hospital Emergency Facility and Provider

Section 19-712.6 - Continuing Care Facility

Section 19-712.7 - Reimbursement to Community Health Resources

Section 19-713 - Rates and Contracts

Section 19-713.1 - Contracts Between Health Maintenance Organization and Subscribers

Section 19-713.2 - Administrative Service Provider Contracts

Section 19-713.3 - Administrative Service Contracting Provider

Section 19-713.4 - Providing Pharmaceutical Services

Section 19-713.5 - Uniform Consultation Referral Form

Section 19-713.6 - Drug Therapy Management

Section 19-714 - Marketing Documents

Section 19-715 - Application or Offer of Enrollment

Section 19-716 - Availability of Information to Members and General Public

Section 19-717 - Annual Reports

Section 19-719 - Health Care Services; Examination

Section 19-720 - Health Services Cost Review Commission

Section 19-721 - Expiration of Certificate of Authority

Section 19-722 - Refusal to Renew Certificate; Remedies

Section 19-723 - Supervision of Health Maintenance Organizations

Section 19-724 - Solicitation of Members

Section 19-725 - Cancellation of Enrollment

Section 19-726 - Prohibited Use of Certain Terms

Section 19-727 - Applicability of Tax Laws

Section 19-728 - Responsibilities of Department and Commissioner

Section 19-729 - Prohibited Acts; Remedies

Section 19-730 - Penalties -- Violation of 19-729 of This Subtitle

Section 19-731 - Penalties -- Violation of 19-705 and 19-705.1 of This Subtitle

Section 19-732 - Appeal

Section 19-734 - Short Title

Section 19-735 - Foreign Health Maintenance Organization Transferring Domicile to This State