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Maryland · Through 2026-01-01

Md. Code, Insurance § 15–1631

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  1. Article - Insurance

Except for an overpayment as defined in § 15–1629(h) of this subtitle, if a claim has been approved by a pharmacy benefits manager through adjudication, the pharmacy benefits manager may not retroactively deny or modify reimbursement to a pharmacy or pharmacist for the approved claim unless:

(1) the claim was fraudulent;

(2) the pharmacy or pharmacist had been reimbursed for the claim previously; or

(3) the services reimbursed were not rendered by the pharmacy or pharmacist.

Collected 2026-09-14T19:59:28Z. Source file · JSON

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