MD SB438

Maryland Medical Assistance Program must establish minimum (rather than maximum) reimbursement levels for generic drugs, set at least equal to the National Average Drug Acquisition Cost plus the fee-for-service professional dispensing fee based on the state's most recent cost-of-dispensing survey.

Brand name drugs directed by a prescriber must be reimbursed at the National Average Drug Acquisition Cost plus the professional dispensing fee, replacing the previous "cost" standard.

Pharmacy benefits managers contracting with pharmacies on behalf of managed care organizations must reimburse pharmacies at least the National Average Drug Acquisition Cost plus the dispensing fee.

The minimum reimbursement requirements do not apply to pharmacies owned by or affiliated with pharmacy benefits managers, or to mail order pharmacies.

The definition of "purchaser" under pharmacy benefits manager regulations is expanded to include insurers, nonprofit health service plans, and health maintenance organizations, though nonprofit HMOs operating as group models with internal pharmacy operations are excluded.