§ 10125.1
150 words·~1 min read·
/ca/insurance-code/10125-1A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(a)Every insurer issuing disability insurance that covers hospital, medical, or surgical expenses that offers coverage for a service that is within the scope of practice of a duly licensed pharmacist shall pay or reimburse the cost of the service performed by a pharmacist at an in-network pharmacy or a pharmacist at an out-of-network pharmacy if the insurer has an out-of-network pharmacy benefit.
(b)Payment or reimbursement may be made pursuant to this section for a service performed by a duly licensed pharmacist only when all of the following conditions are met:
(1)The service performed is within the lawful scope of practice of the pharmacist.
(2)The coverage otherwise provides reimbursement for identical services performed by other licensed health care providers.
(c)Nothing in this section shall require the insurer to pay a claim to more than one provider for duplicate service or be interpreted to limit physician reimbursement.