Public Health - Patient Access to Medication

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*hb1051*

HOUSE BILL 1051
J1, J2, J5 6lr1108

By: Delegate Rosenberg
Introduced and read first time: February 9, 2026
Assigned to: Health

A BILL ENTITLED

AN ACT concerning 1

Public Health – Patient Access to Medication 2

FOR the purpose of establishing the Meds–to–Beds Program in the Maryland Department 3
of Health and requiring each hospital in the State to participate in the Program; 4
authorizing certain health care facilities to use automated drug dispensing systems 5
and remote dispensing systems subject to certain requirements; authorizing a 6
pharmacy to outsource prescription processing to another pharmacy under certain 7
circumstances; altering the definition of “telehealth” as it applies to certain 8
insurance coverage to include the use of automated drug dispensing systems and 9
remote dispensing systems; and generally relating to patient access to medication. 10

BY adding to 11
Article – Health – General 12
Section 13–5901 and 13 –5902 to be under the new subtitle “Subtitle 59. 13
Meds–to–Beds Program” ; and 19 –2701 and 19–2702 to be under the new 14
subtitle “Subtitle 27. Prescription Drug Dispensing Systems” 15
Annotated Code of Maryland 16
(2023 Replacement Volume and 2025 Supplement) 17

BY repealing and reenacting, with amendments, 18
Article – Health – General 19
Section 15–141.2 20
Annotated Code of Maryland 21
(2023 Replacement Volume and 2025 Supplement) 22

BY adding to 23
Article – Health Occupations 24
Section 12–515 25
Annotated Code of Maryland 26
(2021 Replacement Volume and 2025 Supplement) 27

2 HOUSE BILL 1051

BY repealing and reenacting, with amendments, 1
Article – Insurance 2
Section 15–139 3
Annotated Code of Maryland 4
(2017 Replacement Volume and 2025 Supplement) 5

SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND, 6
That the Laws of Maryland read as follows: 7

Article – Health – General 8

SUBTITLE 59. MEDS–TO–BEDS PROGRAM. 9

13–5901. 10

IN THIS SUBTITLE, “PROGRAM” MEANS THE MEDS–TO–BEDS PROGRAM. 11

13–5902. 12

(A) (1) THERE IS A MEDS–TO–BEDS PROGRAM IN THE DEPARTMENT. 13

(2) THE PURPOSE OF THE PROGRAM IS TO REDUCE HOSPITAL 14
READMISSIONS BY USING A LICENSED PHA RMACIST TO DELIVER D ISCHARGE 15
MEDICATIONS TO PATIENTS BEFORE THE PATIENT LEAVES THE HOSPITAL. 16

(B) EACH HOSPITAL IN THE STATE SHALL PARTICIPATE IN THE PROGRAM. 17

(C) THE DEPARTMENT SHALL ADOP T REGULATIONS TO CARRY OUT THE 18
PROGRAM. 19

15–141.2. 20

(a) (1) In this section the following words have the meanings indicated. 21

(2) “Distant site” means a site at which the distant site health care provider 22
is located at the time the health care service is provided through telehealth. 23

(3) “Distant site provider” means the health care provider who provides 24
medically necessary services to a patient at an originating site from a different physical 25
location than the location of the patient. 26

(4) “Health care provider” means: 27

HOUSE BILL 1051 3

(i) A person who is licensed, certified, or otherwise authorized under 1
the Health Occupations Article to provide health care in the ordinary course of business or 2
practice of a profession or in an approved education or training program; 3

(ii) A mental health and substance use disorder program licensed in 4
accordance with § 7.5–401 of this article; 5

(iii) A person licensed under Title 7, Subtitle 9 of this article to 6
provide services to an individual with developmental disability or a recipient of individual 7
support services; or 8

(iv) A provider as defined under § 16 –201.4 of this article to provide 9
services to an individual receiving long–term care services. 10

(5) “Originating site” means the location of the Program recipient at the 11
time the health care service is provided through telehealth. 12

(6) “Remote patient monitoring services” means the use of synchronous or 13
asynchronous digital technologies that collect or monitor medical , patient–reported, and 14
other forms of health care data for Program recipients at an originating site and 15
electronically transmit that data to a distant site provider to enable the distant site 16
provider to assess, diagnose, consult, treat, educate, provide care management, suggest 17
self–management, or make recommendations regarding the Program recipient’s health 18
care. 19

(7) (i) “Telehealth” means the delivery of medically necessary somatic, 20
dental, or behavioral health services to a patient at an originatin g site by a distant site 21
provider through the use of technology–assisted communication. 22

(ii) “Telehealth” includes: 23

1. Synchronous and asynchronous interactions; 24

2. An audio –only telephone conversation between a health 25
care provider and a pat ient that results in the delivery of a billable, covered health care 26
service; [and] 27

3. Remote patient monitoring services; AND 28

4. AUTOMATED DRUG DISPEN SING SYSTEMS AND 29
REMOTE DISPENSING SYSTEMS AS THOSE TERMS ARE DEFINED IN § 19–2701 OF THIS 30
ARTICLE. 31

(iii) “Telehealth” does not include the provision of health care 32
services solely through: 33

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1. Except as provided in subparagraph (ii)2 of this 1
paragraph, an audio–only telephone conversation; 2

2. An e–mail message; or 3

3. A facsimile transmission. 4

(b) The Program shall: 5

(1) Provide health care services appropriately delivered through telehealth 6
to Program recipients regardless of the location of the Program recipient at the time 7
telehealth services are provided; and 8

(2) Allow a distant site provider to provide health care services to a 9
Program recipient from any location at which the health care services may be appropriately 10
delivered through telehealth. 11

(c) The services required to be provided under subsection (b) of this section shall 12
include counseling and treatment for substance use disorders and mental health conditions. 13

(d) The Program may not: 14

(1) Exclude from coverage a health care service solely because it is provided 15
through telehealth and is not provid ed through an in –person consultation or contact 16
between a health care provider and a patient; or 17

(2) Exclude from coverage a behavioral health care service provided to a 18
Program recipient in person solely because the service may also be provided through 19
telehealth. 20

(e) The Program may undertake utilization review, including preauthorization, 21
to determine the appropriateness of any health care service whether the service is delivered 22
through an in –person consultation or through telehealth if the appropr iateness of the 23
health care service is determined in the same manner. 24

(f) The Program may not distinguish between Program recipients in rural or 25
urban locations in providing coverage under the Program for health care services delivered 26
through telehealth. 27

(g) (1) Subject to paragraph (3) of this subsection, the Program shall 28
reimburse a health care provider for the diagnosis, consultation, and treatment of a 29
Program recipient for a health care service covered by the Program that can be 30
appropriately provided through telehealth. 31

(2) This subsection does not require the Program to reimburse a health 32
care provider for a health care service delivered in person or through telehealth that is: 33

HOUSE BILL 1051 5

(i) Not a covered health care service under the Program; or 1

(ii) Delivered by an out–of–network provider unless the health care 2
service is a self–referred service authorized under the Program. 3

(3) (i) When appropriately provided through telehealth, the Program 4
shall provide reimbursement in accordance with paragraph (1) of this subsection on the 5
same basis and the same rate as if the health care service were delivered by the health care 6
provider in person. 7

(ii) The reimbursement required under subparagraph (i) of this 8
paragraph does not include: 9

1. Clinic facility fees unless the health care service is 10
provided by a health care provider not authorized to bill a professional fee separately for 11
the health care service; or 12

2. Any room and board fees. 13

(h) (1) The Department may specify in regulat ion the types of health care 14
providers eligible to receive reimbursement for health care services provided to Program 15
recipients under this section. 16

(2) If the Department specifies by regulation the types of health care 17
providers eligible to receive rei mbursement for health care services provided to Program 18
recipients under this subsection, the regulations shall include all types of health care 19
providers that appropriately provide telehealth services. 20

(3) For the purpose of reimbursement and any fidel ity standards 21
established by the Department, a health care service provided through telehealth is 22
equivalent to the same health care service when provided through an in –person 23
consultation. 24

(i) Subject to subsection (g)(2) of this section, the Program or a managed care 25
organization that participates in the Program may not impose as a condition of 26
reimbursement of a covered health care service delivered through telehealth that the 27
health care service be provided by a third–party vendor designated by the Program. 28

(j) The Department may adopt regulations to carry out this section. 29

(k) The Department shall obtain any federal authority necessary to implement 30
the requirements of this section, including applying to the Centers for Medicare and 31
Medicaid Services for an amendment to any of the State’s § 1115 waivers or the State plan. 32

(l) This section may not be construed to supersede the authority of the Health 33
Services Cost Review Commission to set the appropriate rates for hospitals, including 34
setting the hospital facility fee for hospital–provided telehealth. 35
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SUBTITLE 27. PRESCRIPTION DRUG DISPENSING SYSTEMS. 1

19–2701. 2

(A) IN THIS SUBTITLE THE FOLLOWING WORDS HAVE THE MEANINGS 3
INDICATED. 4

(B) “ADMINISTRATION” MEANS THE DIRECT APP LICATION OF A 5
CONTROLLED SUBSTANCE BY INJECTION, INHALATION, INGESTION, OR ANY OTHER 6
MEANS TO THE BODY OF A PATIENT BY: 7

(1) AN AUTHORIZED PRESCRIBER OR ANOTHER AUTHORIZED 8
INDIVIDUAL; OR 9

(2) THE PATIENT AT THE DI RECTION AND IN THE P RESENCE OF THE 10
AUTHORIZED PRESCRIBER WHO PRESCRIBED THE CONTROLLED SUBSTANCE. 11

(C) “AUTHORIZED PRESCRIBER” HAS THE MEANING STATED IN § 12–101 OF 12
THE HEALTH OCCUPATIONS ARTICLE. 13

(D) “AUTOMATED DRUG DISPENSING SYSTEM” MEANS A MECHANICAL O R 14
ELECTRONIC SYSTEM TH AT PERFORMS OPERATIO NS OR ACTIVITIES, OTHER THAN 15
COMPOUNDING, AS DEFINED IN § 12–101 OF THE HEALTH OCCUPATIONS ARTICLE, 16
OR ADMINISTRATION, RELATING TO PHARMACY SERVICES, INCLUDING: 17

(1) THE STORAGE, DISPENSING, OR DISTRIBUTION OF DRUGS; AND 18

(2) THE COLLECTION , CONTROL, AND MAINTENANCE OF ALL 19
TRANSACTION INFORMATION REGARDING THE SECURITY OF DRUGS IN THE SYSTEM. 20

(E) “BOARD” MEANS THE STATE BOARD OF PHARMACY. 21

(F) “DISPENSE” HAS THE MEANING STATED IN § 3–401 OF THIS ARTICLE. 22

(G) “DRUG” HAS THE MEANING STATED IN § 21–101 OF THIS ARTICLE. 23

(H) “FACILITY” MEANS A HOSPITAL OR NURSING FACILITY, INCLUDING AN 24
INTERMEDIATE CARE FA CILITY, SKILLED NURSING FACI LITY, COMPREHENSIVE 25
CARE FACILITY, OR EXTENDED CARE FACILITY. 26

HOUSE BILL 1051 7

(I) “PHARMACIST–IN–CHARGE” MEANS A PHARMACIST WHO HOL DS A 1
LICENSE ISSUED BY THE BOARD AND IS DESIGNATED BY A FACI LITY TO ENSURE 2
COMPLIANCE WITH THIS SUBTITLE. 3

(J) “REMOTE DISPENSING SYS TEM” MEANS A PROFILE –DRIVEN 4
AUTOMATED DRUG DISPE NSING SYSTEM THAT PE RFORMS OPERATIONS OR 5
ACTIVITIES RELATING TO THE STORAGE, PACKAGING, LABELING, OR DISPENSING OF 6
MEDICATIONS USING BIDIRECTIONAL AUDIO–VISUAL TECHNOLOGY TO: 7

(1) FACILITATE PHARMACIST COMMUNICATION WITH A PATIENT, AN 8
AUTHORIZED AGENT OF THE PATIENT , OR AN INDIVIDUAL AUTHORIZED TO 9
ADMINISTER DRUGS; AND 10

(2) COLLECT, CONTROL, AND MAINTAIN ALL INF ORMATION 11
REGARDING THE SYSTEM ONLINE. 12

19–2702. 13

(A) A FACILITY MAY USE AN AUTOMATED DRUG DISPE NSING SYSTEM OR 14
REMOTE DISPENSING SYSTEM IF: 15

(1) A DRUG STORED, DISPENSED, OR DISTRIBUTED BY THE 16
AUTOMATED DRUG DISPENSING SYSTEM OR REMOTE DISPENSING SYSTEM IS: 17

(I) PLACED IN THE AUTOMATED DRUG DISPENSING SYSTEM OR 18
REMOTE DISPENSING SYSTEM IN A FACILITY; AND 19

(II) UNDER THE CONTROL OF THE PHARMACY THAT PROVIDES 20
SERVICES TO THE FACILITY; 21

(2) THE PHARMACIST–IN–CHARGE HAS ESTABLISH ED PROCEDURES 22
FOR ENSURING: 23

(I) THE ACCURATE STOCKING AND PROPER STORAGE O F 24
DRUGS IN THE AUTOMAT ED DRUG DISPENSING S YSTEM OR REMOTE DISP ENSING 25
SYSTEM; AND 26

(II) ACCOUNTABILITY FOR AND SECURITY OF ALL DRUGS IN AN 27
AUTOMATED DRUG DISPENSING SYSTEM OR A REMOTE DISPENSING SYSTEM UNTIL 28
THE TIME DRUGS ARE REMOVED FROM THE AUTOMATED DRUG DISPENSING SYSTEM 29
OR REMOTE DISPENSING SYSTEM FOR ADMINISTRATION TO PATIENTS; 30

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(3) THE R EMOVAL OF A DRUG FROM A N AUTOMATED DRUG 1
DISPENSING SYSTEM OR REMOTE DISPENSING SYSTEM FOR ADMINISTRATION TO A 2
PATIENT IS MADE ACCORDING TO: 3

(I) A WRITTEN PRESCRIPTION; 4

(II) AN ELECTRONIC PRESCRIPTION, AS DEFINED IN § 5–101 OF 5
THE CRIMINAL LAW ARTICLE; OR 6

(III) AN ORAL PRESCRIPTION FROM AN AUTHORIZED 7
PRESCRIBER; 8

(4) THE FACILITY PROVIDES ADEQUATE SECURITY FOR AUTOMATED 9
DRUG DISPENSING SYST EMS OR REMOTE DISPEN SING SYSTEMS BY ESTABLISHING 10
AND ADHERING TO WRITTEN POLICIES AND PROCEDURES FOR: 11

(I) PREVENTING UNAUTHORIZED ACCESS; 12

(II) COMPLYING WITH FEDERA L AND STATE REGULATIONS 13
GOVERNING PRESCRIBING AND DISPENSING CONTROLLED SUBSTANCES; 14

(III) MAINTAINING PATIENT CONFIDENTIALITY; AND 15

(IV) ENSURING COMPLIANCE W ITH THE REQUIREMENTS OF 16
THIS SECTION; 17

(5) THE PHARMACIST–IN–CHARGE IS ACCOUNTABLE FOR ALL DRUGS 18
DISPENSED FROM AN AU TOMATED DRUG DISPENS ING SYSTEM OR A REMOTE 19
DISPENSING SYSTEM; 20

(6) SUBJECT TO SUBSECTION (B) OF THIS SECTION, THE FILLING AND 21
STOCKING OF ALL DRUG S IN AN AUTOMATED DRUG DISPE NSING SYS TEM OR A 22
REMOTE DISPENSING SY STEM IS PERFORMED UNDER THE DIRECTION OF THE 23
PHARMACIST–IN–CHARGE AND IN ACCORDANCE WITH STANDARDS DESCRIBED IN A 24
POLICY AND PROCEDURE MANUAL MAINTAINED BY THE PROVIDER PHARMACY; AND 25

(7) EXCEPT WHEN THE AUTOM ATED DRUG DISPENSING SYSTEM IS 26
USED EXCLUSIVELY FOR THE ADMINISTRATION OF DR UGS FOR EMERGENCIES , A 27
PHARMACY LOCATED OUTSIDE THE FACILITY IT SERVICES IS REQUIRED TO OBTAIN: 28

(I) A CONTROLLED SUBSTANCES REGISTRATION ISSUED: 29

HOUSE BILL 1051 9

1. IN THE NAME OF THE PHARMACY AT THE ADDRESS OF 1
THE FACILITY; AND 2

2. BY THE OFFICE OF CONTROLLED SUBSTANCES 3
ADMINISTRATION UNDER § 5–301(A)(1) OF THE CRIMINAL LAW ARTICLE; AND 4

(II) IF REQUIRED, A REGISTRATION FROM THE FEDERAL DRUG 5
ENFORCEMENT ADMINISTRATION BEFORE STOCKING CONTROLLED SUBSTANCES 6
IN SCHEDULES II THROUGH VI UNDER TITLE 5, SUBTITLE 4 OF THE CRIMINAL LAW 7
ARTICLE. 8

(B) (1) THE FILLING AND STOCK ING OF DRUGS INTO A N AUTOMATED 9
DRUG DISPENSING SYST EM OR A REMOTE DISPE NSING SYSTEM SHALL BE 10
PERFORMED BY: 11

(I) A PHARMACIST; OR 12

(II) A REGISTERED PHARMACY TECHNICIAN WHO: 13

1. IS AN EMPLOYEE OF THE PHARMACY THAT IS 14
SUPPLYING THE DRUGS; AND 15

2. IS PROPERLY TRAINED ON STANDARDS FOR FILLING 16
AND STOCKING A N AUTOMATED DRUG DISPENSING SYSTEM OR A REMOTE 17
DISPENSING SYSTEM IN ACCORDANCE WITH THE STANDARDS D ESCRIBED UNDER 18
SUBSECTION (A)(6) OF THIS SECTION. 19

(2) THE PHARMACIST WHO STOCKS AND FILLS AN AUTOMATED DRUG 20
DISPENSING SYSTEM OR A REMOTE DISPENSING SYSTEM OR , IF A N AUTO MATED 21
DRUG DISPENSING SYST EM OR A REMOTE DISPE NSING SYSTEM IS STOCKED AN D 22
FILLED BY A REGISTERED PHARMACY TECHNICIAN, THE PHARMACIST–IN–CHARGE, 23
IS RESPONSIBLE FOR ENSURING THE STANDARDS DESCRIBED IN SUBSECTION (A)(6) 24
OF THIS SECTION HAVE BEEN MET. 25

(C) EXCEPT AS OTHERWISE AUTHORIZED BY THE BOARD, DRUGS PLACED 26
INTO AND REMOVED FRO M AN AUTOMATED DRUG DISPE NSING SYSTEM OR A 27
REMOTE DISPENSING SYSTEM FOR ADMINISTRATION TO PATIENTS SHALL BE: 28

(1) IN THE MANUFACTURER ’S OR DISTRIBUTOR ’S SEALED ORIGINAL 29
PACKAGING; 30

(2) IN UNIT–DOSE CONTAINERS PACKAGED BY THE PHARMACY; OR 31

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(3) IF APPROVED BY THE PH ARMACIST–IN–CHARGE AND IN 1
CONSULTATION WITH THE FACILITY: 2

(I) IN MULTIDOSE PACKAGING; OR 3

(II) IF THE DRUG IS IN A LIQUID , INJECTABLE, OR INHALED 4
FORMULATION, IN A DEVICE, AS DEFINED IN § 3–401 OF THIS ARTICLE. 5

(D) (1) EXCEPT AS PROVIDED IN PARAGRAPH (2) OF THIS SUBSECTION , 6
THE PHARMACIST–IN–CHARGE SHALL ESTABLISH PROCEDURES FOR: 7

(I) PERIODICALLY INSPECTI NG AND AUDITING AUTOMAT ED 8
DRUG DISPENSING SYST EMS AND REMOTE DISPE NSING SYSTEMS TO ENS URE THE 9
PROPER STORAGE, SECURITY, AND ACCOUNTABILITY F OR ALL DRUGS PLACED IN 10
AND REMOVED FROM AUT OMATED DRUG DISPENSI NG SYSTEMS AND REMOT E 11
DISPENSING SYSTEMS; AND 12

(II) REVIEWING THE OPERATI ON AND MAINTENANCE O F 13
AUTOMATED DRUG DISPENSING SYSTEMS AND REMOTE DISPENSING SYSTEMS. 14

(2) IF A PHARMACY IS LOCATED WITHIN A HOSPITAL, A PHARMACIST 15
SHALL REVIEW THE OPE RATION AND MAINTENAN CE OF THE AUTOMATED DRUG 16
DISPENSING SYSTEM OR REMOTE DISPENSING SYSTEM: 17

(I) WHILE ON THE PREMISES OF THE HOSPITAL; AND 18

(II) FOR COMPLIANCE WITH THE PROCEDURES AND 19
REGULATIONS ESTABLISHED BY THE PHARMACIST–IN–CHARGE AND THE BOARD. 20

(E) THE BOARD SHALL ADOPT REGULATIONS: 21

(1) ESTABLISHING MINIMUM REQUIREMENTS FOR: 22

(I) RANDOM PERIODIC INSPECTION AND MONTHLY AUDITS OF 23
AUTOMATED DRUG DISPE NSING SYSTEMS AND RE MOTE DISPENSING SYST EMS TO 24
ENSURE THE PROPER ST ORAGE, SECURITY, AND ACCOUNTABILITY O F ALL DRUGS 25
PLACED IN AND REMOVED FROM THE AUTOMATED DRUG DISPENSING SYSTEMS AND 26
REMOTE DISPENSING SYSTEMS; AND 27

(II) REVIEWING THE OPERATI ON AND MAINTENANCE O F 28
AUTOMATED DRUG DISPENSING SYSTEMS AND REMOTE DISPENSING SYSTEMS; 29

HOUSE BILL 1051 11

(2) IDENTIFYING WHERE AUTOMATED DRUG DISPE NSING SYSTEMS 1
AND REMOTE DISPENSING SYSTEMS MAY BE LOCATED; AND 2

(3) TO ENSURE THE SECURIT Y OF DRUG S, CONFIDENTIALITY OF 3
PROTECTED HEALTH INFORMATION, AND APPROPRIATE RECORD KEEPING. 4

Article – Health Occupations 5

12–515. 6

(A) (1) IN THIS SECTION , “PRESCRIPTION PROCESSING” MEANS ANY OF 7
THE FOLLOWING ACTIVITIES RELATED TO DISPENSING PRESCRIPTION DRUGS: 8

(I) RECEIVING, INTERPRETING, ANALYZING, OR CLARIFYING 9
PRESCRIPTIONS; 10

(II) ENTERING PRESCRIPTION AND PATIENT DATA INTO A DATA 11
PROCESSING SYSTEM; 12

(III) TRANSFERRING PRESCRIPTION INFORMATION; 13

(IV) PERFORMING A PROSPECTIVE DRUG REVIEW; 14

(V) OBTAINING REFILL OR SUBSTITUTION AUTHORIZATIONS OR 15
OTHERWISE COMMUNICAT ING WITH A PRESCRIBER CONCERNIN G A PATIENT ’S 16
PRESCRIPTION; 17

(VI) INTERPRETING CLINICAL DATA FOR PRIOR 18
AUTHORIZATION FOR DISPENSING; 19

(VII) PERFORMING THERAPEUTIC INTERVENTIONS; OR 20

(VIII) PROVIDING DRUG INFORM ATION OR COUNSELING 21
CONCERNING A PATIENT’S PRESCRIPTION TO A PATIENT OR A PATIENT’S AGENT. 22

(2) “PRESCRIPTION PROCESSI NG” DOES NOT INCLUDE THE 23
DISPENSING OF A PRESCRIPTION DRUG. 24

(B) A PHARMACY MAY OUTSOUR CE PRESCRIPTION PROC ESSING TO 25
ANOTHER PHARMACY IN THE STATE OR A PHARMACY LOCATED IN ANOTHER STATE 26
IF: 27

(1) EACH PHARMACY HAS: 28
12 HOUSE BILL 1051

(I) THE SAME OWNER; OR 1

(II) ENTERED INTO A WRITTEN CONTRACT THAT DESCRIBES: 2

1. THE SCOPE OF SERVICES TO BE PROVIDED; AND 3

2. THE RESPONSIBILITIES AND ACCOUNTABILITIES OF 4
EACH PHARMACY IN COM PLIANCE WITH ALL FED ERAL AND STATE LAWS AND 5
REGULATIONS RELATED TO THE PRACTICE OF PHARMACY; 6

(2) EACH PHARMACY COMPLIES WITH STATE LAW AND REGULATION 7
RELATING TO: 8

(I) THE REQUIREMENTS FOR SUP ERVISION OF PHARMACY 9
TECHNICIANS; AND 10

(II) THE DUTIES THAT ARE RESTRICTED TO PHARMACISTS AND 11
PHARMACY TECHNICIANS; 12

(3) A PHARMACIST LICENSED IN THE STATE, REGARDLESS OF THE 13
LOCATION OF THE PHARMACY AT WHICH THE PRESCRIPTION PROCESSING IS BEING 14
PERFORMED, PERFORMS A CHECK FOR ACCURACY ON ALL PRESCRIPTION 15
PROCESSING DONE BY A PHARMACY IN ANOTHER STATE; AND 16

(4) EACH PHARMACY SHARES A COMMON ELECTRONIC FILE OR HA S 17
TECHNOLOGY THAT ALLO WS SUFFI CIENT INFORMATION SHARING NECESSARY TO 18
PERFORM PRESCRIPTION PROCESSING. 19

(C) (1) A PHARMACY THAT OUTSOURCES PRESCRIPTION PROCESSING TO 20
ANOTHER PHARMACY SHA LL PROVIDE NOTICE TO ALL PATIEN TS THAT THE 21
PHARMACY OUTSOURCES PRESCRIPTION PROCESSING. 22

(2) SUBJECT TO PARAGRAPH (3) OF THIS SUBSECTION, A PHARMACY 23
MAY SATISFY THE NOTI FICATION REQUIREMENT UNDER PARAGRAPH (1) OF THIS 24
SUBSECTION BY POSTING A SIGN IN THE PHARMACY IN A LOCATION THAT IS READILY 25
VISIBLE TO THE PUBLIC. 26

(3) THE NOTICE REQUIRED UNDER THIS SUBSECTION SHALL STATE: 27

(I) THE NAME OF ANY CONTR ACT PHARMACY PROVIDI NG 28
PRESCRIPTION PROCESSING; AND 29

HOUSE BILL 1051 13

(II) IF APPLICABLE, THAT THE PHARMACY USES A NETWORK OF 1
PHARMACIES UNDER COMMON OWNERSHIP. 2

(D) (1) EACH PHARMACY SHALL D EVELOP, MAINTAIN, AND MAKE 3
AVAILABLE TO THE PUBLIC A POLICY AND PROCEDURE MANUAL THAT GOVERNS THE 4
OUTSOURCING PRESCRIPTION PROCESSING. 5

(2) THE MANUAL REQUIRED UNDER THIS SUBSECTION SHALL 6
INCLUDE THE FOLLOWING, AT A MINIMUM: 7

(I) THE RESPONSIBILITIES OF EACH PHARMACY INVOLVED IN 8
PRESCRIPTION PROCESSING FOR THE PHARMACY; 9

(II) A LIST OF THE NAMES, ADDRESSES, TELEPHONE NUMBERS, 10
AND PERMIT OR REGISTRATION NUMBERS OF ALL PHARMACIES IN VOLVED IN 11
PRESCRIPTION PROCESSING FOR THE PHARMACY; 12

(III) PROCEDURES FOR PROTEC TING THE CONFIDENTIALIT Y 13
AND INTEGRITY OF PATIENT INFORMATION; 14

(IV) PROCEDURES FOR ENSURI NG THAT PHARMACISTS 15
PERFORMING PROSPECTIVE DRUG REVIEWS HAVE ACCESS TO APPROPRIATE DRUG 16
INFORMATION RESOURCES; 17

(V) PROCEDURES FOR MAINTAINING REQUIRED RECORDS; 18

(VI) PROCEDURES FOR COMPLY ING WITH ALL APPLICA BLE 19
LAWS AND REGULATIONS , INCLUDING LAWS AND REGULATIONS RELATED TO 20
COUNSELING; 21

(VII) PROCEDURES FOR OBJECT IVELY AND SYSTEMATIC ALLY 22
MONITORING AND EVALUATING THE QUALITY OF THE PRESCRIPTION PROCESSING 23
THAT HAS BEEN OUTSOURCE D TO RESOLVE PROBLEMS AND IMPROVE SERVICES ; 24
AND 25

(VIII) PROCEDURES FOR ANNUAL LY REVIEWING THE WRI TTEN 26
POLICIES AND PROCEDURES FOR ANY NEEDED MODIFICATION. 27

(E) A PHARMACY THAT OUTSOURCES PRESCRIPTION PROCESSING SHALL 28
MAINTAIN RECORDS THAT SHOW, FOR EACH PRESCRIPTION PROCESSED: 29

(1) EACH INDIVIDUAL WHO PERFORMED THE PRESCRIPTION 30
PROCESSING; AND 31
14 HOUSE BILL 1051

(2) IF APPLICABLE , THE PHARMACIST WHO REVIEWED THE 1
PRESCRIPTION PROCESSING. 2

(F) (1) A RECORD MAINTAINED UNDER SUBSECTION (E) OF THIS SECTION 3
MAY BE MAINTAINED: 4

(I) SEPARATELY BY EACH PHARMACY; OR 5

(II) IN A COMMON ELECTRONI C FILE SHARED BY BOT H 6
PHARMACIES IF THE SYSTEM CAN PRODUCE A RECORD SHOWING: 7

1. EACH PRESCRIPTION PROCESSING TASK; 8

2. THE IDENTITY OF THE INDIVIDUAL PERFORMING 9
EACH TASK; AND 10

3. THE LOCATION AT WHICH EACH PRESCRIPTION 11
PROCESSING TASK WAS PERFORMED. 12

(2) EACH RECORD SHALL BE: 13

(I) MAINTAINED IN A RETRIEVABLE FORM FOR AT LEAST 2 14
YEARS; AND 15

(II) AVAILABLE FOR INSPECTION BY THE BOARD. 16

(G) THIS SECTION MAY NOT BE CONSTRUED TO PROHIBIT AN INDIVIDU AL 17
EMPLOYEE LICENSED AS A PHARMACIST IN THE STATE FROM ACCESSING THE 18
EMPLOYER PHARMACY’S DATABASE FROM A REMOTE LOCATION FOR THE PURPOSE 19
OF PERFORMING PRES CRIPTION PROCESSING IF THE PHARMACY ESTABLI SHES 20
CONTROLS TO PROTECT THE PRIVACY AND SECURITY OF CONFIDENTIAL RECORDS. 21

Article – Insurance 22

15–139. 23

(a) (1) In this section, “telehealth” means, as it relates to the delivery of health 24
care services, the use of interactive audio, video, or other telecommunications or electronic 25
technology by a licensed health care provider to deliver a health care service within the 26
scope of practice of the health care provider at a location other than the location of the 27
patient. 28

(2) “Telehealth” includes: 29
HOUSE BILL 1051 15

(I) an audio –only telephone conversation between a health care 1
provider and a patient that results in the delivery of a billable, covered health care service; 2
AND 3

(II) AUTOMATED DRUG DISPENSING SYST EMS AND REM OTE 4
DISPENSING SYSTEMS, AS THOSE TERMS ARE DEFINED IN § 19–2701 OF THE HEALTH 5
– GENERAL ARTICLE. 6

(3) “Telehealth” does not include: 7

(i) except as provided in paragraph (2) of this subsection, an 8
audio–only telephone conversation between a health care provider and a patient; 9

(ii) an electronic mail message between a health care provider and a 10
patient; or 11

(iii) a facsimile transmission between a health care provider and a 12
patient. 13

(b) This section applies to: 14

(1) insurers and nonprofit he alth service plans that provide hospital, 15
medical, or surgical benefits to individuals or groups on an expense –incurred basis under 16
health insurance policies or contracts that are issued or delivered in the State; and 17

(2) health maintenance organization s that provide hospital, medical, or 18
surgical benefits to individuals or groups under contracts that are issued or delivered in 19
the State. 20

(c) (1) An entity subject to this section: 21

(i) shall provide coverage under a health insurance policy or 22
contract for health care services appropriately delivered through telehealth regardless of 23
the location of the patient at the time the telehealth services are provided; 24

(ii) may not exclude from coverage a health care service solely 25
because it is provided through telehealth and is not provided through an in –person 26
consultation or contact between a health care provider and a patient; and 27

(iii) may not exclude from coverage or deny coverage for a behavioral 28
health care service that is a covered benefit un der a health insurance policy or contract 29
when provided in person solely because the behavioral health care service may also be 30
provided through a covered telehealth benefit. 31

16 HOUSE BILL 1051

(2) The health care services appropriately delivered through telehealth 1
shall include counseling and treatment for substance use disorders and mental health 2
conditions. 3

(d) (1) Subject to paragraph (2) of this subsection, an entity subject to this 4
section: 5

(i) shall reimburse a health care provider for the diagnosis, 6
consultation, and treatment of an insured patient for a health care service covered under a 7
health insurance policy or contract that can be appropriately provided through telehealth; 8

(ii) is not required to: 9

1. reimburse a health care provider for a health care service 10
delivered in person or through telehealth that is not a covered benefit under the health 11
insurance policy or contract; or 12

2. reimburse a health care provider who is not a covered 13
provider under the health insurance policy or contract; and 14

(iii) 1. may impose a deductible, copayment, or coinsurance 15
amount on benefits for health care services that are delivered either through an in–person 16
consultation or through telehealth; 17

2. may impose an annual dollar maximum as permitted by 18
federal law; and 19

3. may not impose a lifetime dollar maximum. 20

(2) (i) When a health care service is appropriately provided through 21
telehealth, an entity subject to this section shall provide reimbursement in accordance with 22
paragraph (1)(i) of this subsection on the same basis and at the same rate as if the health 23
care service were delivered by the health care provider in person. 24

(ii) The reimbursement required under subparagraph (i) of this 25
paragraph does not include: 26

1. clinic facility fees unless the health care service is 27
provided by a health care provider not authorized to bill a professional fee separately for 28
the health care service; or 29

2. any room and board fees. 30

(iii) This paragraph may not be construed to supersede the authority 31
of the Health Services Cost Review Commission to set the appropriate rates for hospitals, 32
including setting the hospital facility fee for hospital–provided telehealth. 33

HOUSE BILL 1051 17

(e) Subject to subsection (d)(1)(ii) of this section, an entity subject to this se ction 1
may not impose as a condition of reimbursement of a covered health care service delivered 2
through telehealth that the health care service be provided by a third –party vendor 3
designated by the entity. 4

(f) An entity subject to this section may undert ake utilization review, including 5
preauthorization, to determine the appropriateness of any health care service whether the 6
service is delivered through an in –person consultation or through telehealth if the 7
appropriateness of the health care service is determined in the same manner. 8

(g) A health insurance policy or contract may not distinguish between patients in 9
rural or urban locations in providing coverage under the policy or contract for health care 10
services delivered through telehealth. 11

(h) A deci sion by an entity subject to this section not to provide coverage for 12
telehealth in accordance with this section constitutes an adverse decision, as defined in § 13
15–10A–01 of this title, if the decision is based on a finding that telehealth is not medically 14
necessary, appropriate, or efficient. 15

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect 16
October 1, 2026. 17