§ 4079
213 words·~1 min read·
/ca/business-and-professions-code/4079A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)A pharmacy shall inform a customer at the point of sale for a covered prescription drug whether the retail price is lower than the applicable cost-sharing amount for the prescription drug, unless the pharmacy automatically charges the customer the lower price.
(b)If the customer pays the retail price, the pharmacy shall submit the claim to the health care service plan or health insurer in the same manner as if the customer had purchased the prescription drug by paying the cost-sharing amount when submitted by the network pharmacy.
(c)The payment rendered shall constitute the applicable cost sharing and shall apply to the deductible, if any, and also to the maximum out-of-pocket limit in the same manner as if the enrollee had purchased the prescription drug by paying the cost-sharing amount.
(d)A contract provision that is inconsistent with this section is void and unenforceable.
(e)The provisions of this section are severable. If any provision of this section or its application is held invalid, that invalidity shall not affect other provisions or applications that can be given effect without the invalid provision or application.
(f)A violation of this provision shall not be grounds for disciplinary action or a criminal action.
(g)This section shall become operative on January 1, 2020.