Practice Agreement · PharmD
Maryland Prescriber-Pharmacist Agreement for Pharmacists
Required. The Prescriber-Pharmacist Agreement is the written instrument Maryland law names for a Pharmacist working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
Represents Maryland's optional prescriber-pharmacist Drug Therapy Management (DTM) agreement tier under COMAR 10.34.29, not ordinary pharmacist licensure — base dispensing needs no agreement. Requires a PharmD (or documented equivalent training) plus 1,000 hours of relevant clinical experience (or 320 hours in an approved structured program) and disease-state-specific credentialing; no independence pathway once entered.
What a Maryland Prescriber-Pharmacist Agreement must contain
Governed by the Maryland Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
Maryland does not require the Pharmacist to hold a prescriber-pharmacist agreement in order to practice pharmacy generally. To provide drug therapy management to a specific patient, however, the Pharmacist and the Physician shall enter into a written prescriber-pharmacist agreement and an accompanying condition- or disease-state-specific protocol, as authorized by Health Occupations Article §§ 12-6A-01 to 12-6A-10 and COMAR 10.34.29. To participate, the Pharmacist shall be licensed and in good standing with the Maryland Board of Pharmacy, hold a Doctor of Pharmacy degree or documented equivalent training, and meet the Board's advanced-training and clinical-experience requirements for the disease state covered by the protocol.
The Parties shall give the Maryland Board of Pharmacy any notice of the prescriber-pharmacist agreement, and of its amendments, that the Board's then-current published requirements call for.
- The Prescriber-Pharmacist Agreement on file also carries 2 scope, 1 education, 1 registration, 1 authority clauses, generated in the document itself.
Statutes and rules cited
- COMAR 10.34.29 (Drug Therapy Management)regulation
Maryland Board of Pharmacy regulation implementing Health Occupations Article §§ 12-6A-01 to 12-6A-10, governing prescriber-pharmacist agreements, protocols, and therapy management contracts.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
As needed
COMAR 10.34.29.05 requires the pharmacist to notify the authorized prescriber within 48 hours (unless the agreement states otherwise) whenever the pharmacist modifies a dose/agent, detects an abnormal assessment result, or initiates drug therapy under a physician-pharmacist written protocol — an event-driven notification duty rather than a fixed recurring meeting.
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
Under a prescriber-pharmacist agreement, the pharmacist may modify, continue, or discontinue drug therapy and order labs per a written, disease-state-specific protocol (COMAR 10.34.29.02) — this is delegated drug-therapy management, not independent DEA-registered controlled-substance prescribing, so controlledSubstancesAllowed is coded False here; only a licensed physician/pharmacist protocol may additionally authorize initiating drug therapy, and whether that extends to controlled substances was not confirmed in this pass.
Written agreement
Required
Only required if the pharmacist and an authorized prescriber (physician, podiatrist, or certified APRN with prescriptive authority) elect to engage in drug therapy management under a written protocol and prescriber-pharmacist agreement (COMAR 10.34.29) — a pharmacist's base license and general dispensing authority need no such agreement.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — No pharmacist-ownership requirement was identified for Maryland pharmacy permits in this pass — not independently confirmed against a specific statute/reg; treat as consistent with the typical non-restrictive pharmacy-ownership pattern seen in other states rather than a settled Maryland-specific finding.
Materially more permissive than the physician-only Professional Corporation regime governing PA/APRN entities above, if confirmed.
Legal sources for these rules (2)
- COMAR 10.34.29 — Drug Therapy Management
- Md. Health Occupations Code §§ 12-6A-01 – 12-6A-10 — Drug Therapy Management (statutory authority for COMAR 10.34.29)
About Maryland's rules
Maryland's APRN categories are NOT uniform: CRNPs/CNMs gained full practice authority in 2015 (after an 18-month new-graduate mentorship), but CRNAs remain fully supervised with NO prescriptive authority at all (Maryland is one of ~11 states granting CRNAs none), and only the psychiatric-mental-health population focus of CNS practice is independent. Maryland does not recognize PLLCs — professional entities use physician-only Professional Corporations, so multi-disciplinary PC ownership questions are open items below.
Other clinicians in Maryland: see the state overview.