Maryland Statutes

§ 15-1631

Maryland·Article gin Insurance·Title 15

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.

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Nearby Sections

15
§ 15-1001
§ 15-1001
§ 15-1002
§ 15-1002
§ 15-1003
§ 15-1003
§ 15-1004
§ 15-1004
§ 15-1005
§ 15-1005
§ 15-1006
§ 15-1006
§ 15-1007
§ 15-1007
§ 15-1008
§ 15-1008
§ 15-1009
§ 15-1009
§ 15-101
§ 15-101
§ 15-1010
§ 15-1010
§ 15-1011
§ 15-1011
§ 15-102
§ 15-102
§ 15-103
§ 15-103
§ 15-104
§ 15-104
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