Maryland Register

Issue Date:  September 14, 2018

Volume 45 • Issue 19 • Pages 869—870

Title 10 
MARYLAND DEPARTMENT OF HEALTH

Subtitle 09 MEDICAL CARE PROGRAMS

Notice of Proposed Action

[18-240-P]

The Secretary of Health proposes to:

(1) Amend Regulation .01 under COMAR 10.09.03 Pharmacy Services; and

(2) Adopt new Regulations .01—.08 under a new chapter, COMAR 10.09.21 Pharmacists.

Statement of Purpose

The purpose of this action is to, in accordance with Chapters 820 and 821 of 2017:

(1) Update the definition of pharmacist to reflect that a pharmacist’s scope of practice includes services beyond filling prescriptions; and

(2) Establish requirements for individual pharmacists who enroll in the Program in order to counsel and prescribe certain contraceptive medications and self-administered contraceptive devices to Medical Assistance participants.

Comparison to Federal Standards

There is no corresponding federal standard to this proposed action.

Estimate of Economic Impact

The proposed action has no economic impact.

Economic Impact on Small Businesses

The proposed action has minimal or no economic impact on small businesses.

Impact on Individuals with Disabilities

The proposed action has no impact on individuals with disabilities.

Opportunity for Public Comment

Comments may be sent to Michele Phinney, Director, Office of Regulations and Policy Coordination, Maryland Department of Health, 201 W. Preston Street, or call 410-767-6499, or email to mphinney@maryland.gov, or fax to 410-767-6483. Comments will be accepted through October 15, 2018. A public hearing has not been scheduled.

10.09.03 Pharmacy Services

Authority: Health-General Article, §§2-104(b), 15-103, 15-103.1, 15-105, [and] 15-118, and 15-148(c), Annotated Code of Maryland

.01 Definitions

A. (text unchanged)

B. Terms Defined.

(1)—(30) (text unchanged)

(31) 'Pharmacist' means an individual licensed in good standing to practice pharmacy in the state where the [prescription is filled] service is provided.

(32)—(46) (text unchanged)

10.09.21 Pharmacists

Authority: Health-General Article, §2-104(b), 2-105(b), 15,-103, and 
15-148(c), Annotated Code of Maryland

.01 Purpose and Scope.

This chapter establishes requirements for individual pharmacists who enroll in the Program.

.02 Definitions.

A. In this chapter, the following terms have the meanings indicated.

B. Terms Defined.

(1) “Board” means the Maryland Board of Pharmacy.

(2) “Contraceptives” means contraceptive medications and self-administered contraceptive devices approved by the U.S. Food and Drug Administration.

(3) “Maryland Medical Assistance Program” means the program of comprehensive medical and other health-related care for indigent and medically indigent individuals.

(4) “Participant” means an individual who is certified as eligible for, and is receiving, Medical Assistance benefits.

(5) 'Pharmacist' means an individual licensed in good standing to practice pharmacy in the state where the service is provided.

(6) “Pharmacy” means an establishment or institution licensed in good standing that is required to obtain a permit in accordance with Health Occupations Article, Title 12, Annotated Code of Maryland.

(7) “Primary care practitioner” means a licensed health care practitioner who provides an individual’s primary care services and is the primary coordinator of health care services for the individual.

(8) “Program” means the Maryland Medical Assistance Program.

(9) “Reproductive health care practitioner” means a licensed health care practitioner who is authorized to provide reproductive health services.

.03 Provider Qualifications and Conditions for Participation.

A. The pharmacist shall meet:

(1) Licensure requirements set forth in COMAR 10.09.36.02; and

(2) Conditions for participation set forth in COMAR 10.09.36.03.

B. A pharmacist who prescribes contraceptives shall:

(1) Meet all Board requirements to prescribe contraceptives set forth in COMAR 10.34.40.03;

(2) Have completed a Board-approved training program, as set forth in COMAR 10.34.40.04;

(3) Meet all record keeping requirements set forth in COMAR 10.34.40.05; and

(4) Meet all continuing education requirements set forth in COMAR 10.34.40.06.

.04 Covered Services.

The following services are covered under this chapter:

A. A patient assessment performed at the pharmacist’s practice location in order to determine:

(1) Whether to prescribe contraceptives; and

(2) Which contraceptive options to prescribe; and

B. If contraceptives are prescribed, a referral:

(1) To the participant’s primary care practitioner or reproductive health care practitioner; or

(2) If the participant does not have a primary care practitioner or a reproductive health care practitioner, to a family planning provider or a licensed clinician who provides reproductive health care services.

.05 Limitations.

A pharmacist may not prescribe contraceptives before January 1, 2019.

.06 Payment Procedures.

A. The provider shall submit the request for payment of services rendered according to procedures established by the Department and in the form designated by the Department.

B. The Department reserves the right to return to the provider, before payment, all invoices not properly signed, completed, and accompanied by properly completed forms required by the Department.

C. Payment advances are not made routinely.

D. The Program will make no direct payment to participants.

E. Billing time limitations for claims submitted pursuant to this chapter are set forth in COMAR 10.09.36.06.

.07 Recovery and Reimbursement.

Recovery and reimbursement are as set forth in COMAR 10.09.36.07.

.08 Cause for Suspension of Removal and Imposition of Sanctions.

Causes for suspension or removal and imposition of sanctions are as set forth in COMAR 10.09.36.08.

ROBERT R. NEALL
Secretary of Health

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