§ 15-1631
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/md/insurance/15-1631A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
§15–1631.
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.