Md. Code, Insurance § 15-1631
This is the official text of Md. Code, Insurance § 15-1631, part of Maryland’s Code, Insurance — regulates insurance companies and the policies they sell.
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§15–1631.
Official statutory text
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.
(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.
Status: in_force · Read it on the official government site
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