Current through 2024 Legislative Session Act Chapter 531
Section 3325A - Reimbursement for and provision of pharmacy goods or services(a) For purposes of this section: (1) "Affiliate" means a pharmacy or pharmacist that directly or indirectly, through 1 or more intermediaries, owns or controls, is owned or controlled by, or is under common ownership or control with, a pharmacy benefits manager.(2) "Pharmaceutical wholesaler" means a person that sells and distributes a pharmaceutical product and offers regular and private delivery to a pharmacy.(3) "Pharmacy acquisition cost" means the amount that a pharmaceutical wholesaler charges for a pharmaceutical product as listed on the pharmacy's billing invoice.(4) "Pharmacy goods or services" means 1 or more of the following provided by a pharmacist or pharmacy: a. A single-sourced drug, multi-sourced drug, or compounded drug.(b) A pharmacy benefits manager may not reimburse a pharmacist or pharmacy for pharmacy goods or services in an amount less than the amount the pharmacy benefits manager reimburses itself or an affiliate for the same pharmacy goods or services.(c) If the amount reimbursed by a pharmacy benefits manager for pharmacy goods or services is less than the pharmacy acquisition cost for the same pharmacy goods or services, a pharmacist or pharmacy may decline to provide the pharmacy goods or services to a patient.(d) A pharmacist or pharmacy acting under subsection (c) of this section shall do all of the following: (1) Inform the patient that the pharmacist or pharmacy has made the decision not to provide pharmacy goods or services to the patient under subsection (c) of this section because of the costs associated with providing the pharmacy goods or services.(2) Provide the patient with a list of pharmacies in the area that may provide the pharmacy goods or services.Added by Laws 2021, ch. 256,s 5, eff. 10/26/2021.