62 Pa. Stat. § 457

Current through P.A. Acts 2023-32
Section 457 - Pharmacy management systems
(a) Each Commonwealth pharmacy program shall develop and implement:
(1) an online claims adjudication system; and
(2) a uniform, coordinated and standardized auditing procedure. Nothing shall preclude the implementation of successful systems and auditing procedures utilized in an existing Commonwealth pharmacy program.
(b) Each Commonwealth pharmacy program shall ensure that a therapeutic drug utilization review system is established to monitor and correct misutilization of drug therapies. The system shall provide prospective and retrospective analysis of potentially dangerous drug interactions, duplicative therapies, maximum allowable dosing, therapy duration and drug utilization. Nothing shall preclude the implementation of successful systems utilized in an existing Commonwealth pharmacy program.
(c) Each Commonwealth pharmacy program shall ensure that a surveillance utilization review system is established to monitor, identify and investigate potential drug misutilization. The system shall monitor potential fraud and abuse by enrollees, providers and prescribers for all appropriate Commonwealth pharmacy programs. Nothing shall preclude the implementation of successful systems utilized in an existing Commonwealth pharmacy program.
(d) Each Commonwealth pharmacy program shall establish a procedure to ensure that, notwithstanding the provisions of the act of November 24, 1976 (P.L. 1163, No. 259), referred to as the Generic Equivalent Drug Law, a brand name product shall be dispensed and not substituted with an A-rated generic therapeutically equivalent drug if it is the least expensive alternative for the specific Commonwealth pharmacy program.

62 P.S. § 457

1967, June 13, P.L. 31, No. 21, art. 4, § 457, added 2005, July 7, P.L. 177, No. 42, § 6, imd. effective.