Sec. 4. Information on prescription drugs
337 words·~2 min read·
/bill/118/hr/4507/rh/section-4·A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
Subpart B of part 7 of subtitle B of title I of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1185 et seq. ), as amended by section 3, is further amended by adding at the end the following new section: A group health plan or a health insurance issuer offering group health insurance coverage shall— not restrict, directly or indirectly, any pharmacy that dispenses a prescription drug to a participant of beneficiary in the plan or coverage from informing (or penalize such pharmacy for informing) a participant or beneficiary of any differential between the participant’s or beneficiary’s out-of-pocket cost under the plan or coverage with respect to acquisition of the drug and the amount an individual would pay for acquisition of the drug without using any health plan or health insurance coverage; and ensure that any entity that provides pharmacy benefits management services under a contract with any such health plan or health insurance coverage does not, with respect to such plan or coverage, restrict, directly or indirectly, a pharmacy that dispenses a prescription drug from informing (or penalize such pharmacy for informing) a participant or beneficiary of any differential between the participant’s or beneficiary’s out-of-pocket cost under the plan or coverage with respect to acquisition of the drug and the amount an individual would pay for acquisition of the drug without using any health plan or health insurance coverage.
For purposes of this section, the term out-of-pocket cost , with respect to acquisition of a drug, means the amount to be paid by the participant or beneficiary under the plan or coverage, including any cost-sharing (including any deductible, copayment, or coinsurance) and, as determined by the Secretary, any other expenditure. . The table of contents in section 1 of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1001 et seq. ), as amended by section 3, is further amended by inserting after the item relating to section 726 the following new item:
Sec. 727. Information on prescription drugs. .
Connectionstraces to 2
Traces to 2 documents
Citation graph
cites case law
Cites 2Cited by 0 across 0 sources