COMAR 10.09.03.05-1. Expanded Limitations
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Code of Maryland Regulations › Title 10 MARYLAND DEPARTMENT OF HEALTH › Subtitle 09 MEDICAL CARE PROGRAMS › Chapter 03 Pharmacy Services › COMAR 10.09.03.05-1
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A. A drug is not covered for State-only participants if:
(1) The manufacturer has not provided the same rebate to the State for State-only participants’ purchases of drugs as is required under Section 1927(c) of Title XIX of the Social Security Act (42 U.S.C. §1396r-8(c));
(2) The Program has provided notice to the manufacturer of the manufacturer's failure to provide adequate rebates and its opportunity to request a waiver from the rebate requirement under §A(3) of this regulation ; and
(3) The manufacturer has failed to demonstrate to the Secretary that the drug’s availability is essential to State-Only participants.
B. A manufacturer or its designee may not dispute or request repayment of any rebate paid under §A(1) of this regulation or under 42 U.S.C. §1396r-8(c) more than 3 years after the date the rebate was paid.
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