HB 751 - Demographic Information

BULLETIN 19-16 To: Insurers, nonprofit health service plans, and health maintenance organizations that provide coverage for prescription drugs (Carriers) Re: HB 751; Demographic Information Date: September 19, 2019 HB 751 requires carriers to collect Demographic Information under certain circumstances. The purpose of this Bulletin is to set forth the information that should be collected. As you are aware, effective January 1, 2020, HB 751 states: For a prior authorization that is filed electronically, the entity shall maintain a database that will prepopulate prior authorization requests with an insured’s available insurance and demographic information. In order to comply with HB 751, a Carrier should collect the following Demographic Information: name, date of birth, gender, address, group number, member identification number, telephone number and email address. If the Carrier routinely collects, and requires in order to consider a prior authorization request complete, any other insurance or demographic information, the Carrier shall maintain that information as part of the database. The statute applies to all carriers that provide coverage for prescription drugs, regardless of whether the carrier delegates the requirement to a pharmacy benefit manager (PBM) or private review agent (PRA). Questions about this Bulletin may be directed to Erica Bailey, Associate Commissioner of Compliance and Enforcement of the Maryland Insurance Administration at 410-468-2113. AL REDMER, JR. Commissioner By: __ Erica Bailey Associate Commissioner Compliance & Enforcement AL REDMER, JR. Commissioner NANCY GRODIN Deputy Commissioner LARRY HOGAN Governor BOYD K. RUTHERFORD Lt. Governor 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 1-800-492-6116 TTY: 1-800-735-2258 www.insurance.maryland.gov signature on original