SB 84
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
Enrolled - Revised
Senate Bill 84 (Senators Young and Waldstreicher)
Education, Health, and Environmental Affairs Health and Government Operations
Pharmacists – Administration of Self–Administered Medications and
Maintenance Injectable Medications (Christopher King Access to Treatment
Act)
This emergency bill authorizes a licensed pharmacist to administer a “maintenance
injectable medication” that is not a biological product to a patient under specified
circumstances. By September 1, 2021, the State Board of Pharmacy, along with the State
Board of Physicians and the State Board of Nursing, must adopt regulations establishing
specified standard procedures. Specified insurers, nonprofit health service plans, and health
maintenance organizations, as well as Medicaid and the Maryland Children’s Health
Program (MCHP), must provide coverage for the administration of a self-administered
medication or maintenance injectable medication rendered by a licensed pharmacist to the
same extent as services rendered by any other licensed health care practitioner for patient
assessment regarding and administration of self-administered or maintenance injectable
medications. The bill’s insurance provisions apply to all policies and contracts issued,
delivered, or renewed in the State on or after January 1, 2022.
Fiscal Summary
State Effect: Minimal increase in special fund revenues for the Maryland Insurance
Administration (MIA) in FY 2022 from the $125 rate and form filing fee. MIA can likely
review additional filings with existing resources. The State Board of Pharmacy can adopt
and implement regulations with existing budgeted resources. No impact on
Medicaid/MCHP or the State Employee and Retiree Health and Welfare Benefits Program.
Local Effect: None.
Small Business Effect: Potential meaningful.
 Analysis
Bill Summary: “Maintenance injectable medication” means a medication that (1) is
administered by injection other than intravenously and (2) treats a chronic need, condition,
or disorder. “Maintenance injectable medication” includes a medication for the treatment
of a psychiatric or substance use disorder, contraception, and vitamins.
A licensed pharmacist may administer a maintenance injectable medication that is not a
biological product to a patient (1) that is prescribed by an authorized prescriber; (2) in
accordance with a standing order issued by an authorized public health official; or (3) in
accordance with a drug therapy management protocol. A pharmacist may not administer
an initial dose of a maintenance injectable medication product without written approval
from the prescriber.
The boards must adopt regulations establishing standard procedures (1) for notifying a
patient about payment for services before the pharmacist administers a maintenance
injectable medication; (2) that a pharmacist must use to administer a maintenance
injectable medication; and (3) for communicating to the prescriber whether a medication
was administered and relevant information about the patient’s condition.
Regulations establishing standard procedures for the administration of a maintenance
injectable medication must require a pharmacist to (1) complete a board-approved training
program (unless the pharmacist has received this training as part of the pharmacist’s formal
educational training); (2) follow the standard procedures established by the board; (3) after
administering a maintenance injectable medication, notify the prescriber, provide the
patient with a written record, and record specified information in the patient’s health
record; and (4) notify the patient of the need to attend any upcoming appointments the
patient has scheduled with the prescriber.
Current Law: An individual must be licensed by the State Board of Pharmacy to practice
pharmacy in the State. The practice of pharmacy includes compounding, dispensing, or
distributing prescription drugs or devices; monitoring prescriptions; providing information,
explanation, and recommendations to patients and health care practitioners about the safe
and effective use of prescription drugs or devices; providing drug therapy management;
administering vaccinations; and administering a self-administered drug to a patient in
accordance with regulations adopted by the board.
To administer vaccinations, a pharmacist must submit a registration form to the board that
includes verification that the pharmacist has successfully completed a specified
certification course and is certified in cardiopulmonary resuscitation.
SB 84/ Page 2
Chapters 820 and 821 of 2017 expanded the scope of practice for a licensed pharmacist,
who meets specified requirements, to include prescribing and dispensing contraceptive
medications and self-administered contraceptive devices approved by the U.S. Food and
Drug Administration.
The Drug Therapy Management Program authorizes physicians and pharmacists to enter
into a therapy management contract that specifies treatment protocols for patient care. An
authorized prescriber who has entered into such an agreement must submit specified
documentation to the State Board of Pharmacy.
Small Business Effect: Small business pharmacies may administer maintenance
injectable medications and receive reimbursement under the bill.
Additional Information
Prior Introductions: Similar legislation, HB 656 of 2020, passed the House but received
no further action from the Senate Education, Health, and Environmental Affairs and
Finance committees. Its cross file, SB 545, received a hearing in the Senate Education,
Health, and Environmental Affairs Committee, but no further action was taken. Similar
legislation, HB 419 of 2019, received a hearing in the House Health and Government
Operations Committee, but no further action was taken. Its cross file, SB 577, received a
hearing in the Senate Education, Health, and Environmental Affairs Committee, but no
further action was taken.
Designated Cross File: HB 135 (Delegate K. Young) - Health and Government
Operations.
Information Source(s): Department of Budget and Management; Maryland Insurance
Administration; Department of Legislative Services
Fiscal Note History: First Reader - January 19, 2021
rh/ljm Third Reader - March 22, 2021
Revised - Amendment(s) - March 22, 2021
Enrolled - April 10, 2021
Revised - Amendment(s) - April 10, 2021
Analysis by: Jennifer B. Chasse Direct Inquiries to:
(410) 946-5510
(301) 970-5510
SB 84/ Page 3


Statutes affected:
Text - First - Pharmacists – Administration of Self–Administered Medications and Maintenance Injectable Medications: 15-148 Health General, 12-101 Health Occupations, 12-509 Health Occupations, 15-716 Insurance
Text - Third - Pharmacists – Administration of Self–Administered Medications and Maintenance Injectable Medications: 15-148 Health General, 12-101 Health General, 12-509 Health General, 15-716 Health General
Text - Enrolled - Pharmacists – Administration of Self–Administered Medications and Maintenance Injectable Medications: 15-148 Insurance, 12-101 Health Occupations, 12-509 Health Occupations, 15-716 Insurance