Maryland

Multiple DPC practices are in operation in Maryland.  In 2009 A former Maryland insurance commissioner issued harsh guidance to prevent a planned DPC practice transition.  The Report on “Retainer” or “Boutique” or “Concierge” Medical Practices and the Business of Insurance can still be viewed, but is not necessarily endorsed by the current insurance commissioner.  To the best of our knowledge the current insurance commissioner is taking the common "wait and see" approach that is being used in many other states.  We are not aware of any proposed legislation.  Please be sure to also review Title 31 of the Maryland Insurance Administration, note that Maryland makes it very difficult to conduct any in-office dispensing.  One of the motivations for states to have restrictive dispensing laws were historic abuses within the workers compensation arena (and also here).

For a Maryland physician to dispense medications the physician must submit a detailed application to the Maryland Board of Physicians and include a $1,050 fee.  A litany of requirements must be met (some are listed at the bottom of this page).  Customized continuing education related to dispensing is required (here is a group of them available from the Maryland State Medical Society). One must submit to inspections and submit information to the board. Dispensing must be "in the public interest" - which in the board's eyes means that a pharmacy is not conveniently available to the patient.

"Licensed dentists, physicians, and podiatrists are required to obtain a dispensing permit if they dispense prescription drugs to patients under their direct care who have informed the provider that a pharmacy is not conveniently available. The licensee shall maintain documentation that should include a single form in each patient's chart for each patient to whom prescription drugs are dispensed. At a minimum, the form shall:
(1) Indicate the reason, as stated by the patient, that a pharmacy is not conveniently available to that patient;
(2) Include a statement signed by the patient indicating that the patient understands that the determination that a pharmacy is not conveniently available is made solely by the patient; and
(3) Be signed and dated by the patient before dispensing prescription drugs to the patient for the first time. See COMAR 10.13.01.04."