44-4614. Choice of pharmacy services; prohibited acts.
252 words·~1 min read·
/ne/chapter-44/44-4614A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
(1)A health benefit plan, health carrier, or pharmacy benefit manager shall not:
(a)Require a covered person, as a condition of payment or reimbursement, to obtain pharmacist services exclusively through the mail-order pharmacy or pharmacy benefit manager affiliate;
(b)Prohibit or limit a covered person from selecting a network pharmacist or network pharmacy of the covered person's choice;
(c)Transfer a covered person's prescriptions from a network pharmacy to another pharmacy unless requested by the covered person;
(d)Use financial incentives, including, but not limited to, adjustments in cost-sharing obligations of a covered person, to the exclusive benefit of the pharmacy benefit manager affiliate pharmacy; or
(e)Except as provided in subdivision (2)(b) of this section, auto-enroll a covered person in mail-order pharmacist services.
(2)Nothing in this section shall be construed to prevent a health benefit plan, health carrier, or pharmacy benefit manager from:
(a)Requiring a covered person to use a network specialty pharmacy;
(b)Auto-enrolling a covered person in mail-order pharmacist services for a maintenance medication, provided that a covered person:
(i)Shall not be auto-enrolled for the first ninety days of a new maintenance medication; and
(ii)Shall have the ability to opt out of mail-order pharmacist services at any time;
(c)Informing a covered person of an ability to obtain pharmacist services at a lower cost; or
(d)Requiring a covered person to obtain pharmacist services from a mail-order pharmacy or pharmacy benefit manager affiliate when such services are not otherwise available from another network pharmacy.