Current through 2024, ch. 69
Section 59A-61-9 - Prohibition on discrimination against a covered entityA. As used in this section:(1) "340B drug" means a drug that is purchased at a discount in accordance with the 340B program requirements;(2) "340B program" means the federal drug pricing program created pursuant to 42 U.S.C. Section 256b; (3) "covered entity" means an entity participating in the 340B program; and(4) "pharmacy benefits manager" means an entity that provides pharmacy benefits management services.B. A pharmacy benefits manager or a third party shall not discriminate against a covered entity on the basis of its participation in the 340B program by: (1) reimbursing a covered entity for a 340B drug at a rate lower than that paid for the same drug to pharmacies, similar in prescription volume, that are non-covered entities;(2) assessing a fee, chargeback or other adjustment to the covered entity that is not assessed to non-covered entities;(3) imposing a provision that prevents or interferes with a person's choice to receive 340B drugs from a covered entity; or(4) imposing terms or conditions that differ from terms or conditions imposed on a non-covered entity, including:(a) restricting or requiring participation in a pharmacy network;(b) requiring more frequent auditing or a broader scope of audit for inventory management systems using generally accepted accounting principles;(c) requiring a covered entity to reverse, resubmit or clarify a claim after the initial adjudication, unless these actions are in the normal course of pharmacy business and not related to the 340B program; or(d) charging an additional fee or provision that prevents or interferes with an individual's choice to receive a 340B drug from a covered entity.Added by 2023, c. 206,s. 7, eff. 6/13/2023.