§ 300gg–19b. Information on prescription drugs
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/usc/title-42/section-300gg-19bA research copy — for the controlling text, always check the official state or federal source. Not legal advice.
A group health plan or a health insurance issuer offering group or individual health insurance coverage shall— not restrict, directly or indirectly, any pharmacy that dispenses a prescription drug to an enrollee in the plan or coverage from informing (or penalize such pharmacy for informing) an enrollee of any differential between the enrollee’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) an enrollee of any differential between the enrollee’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 enrollee under the plan or coverage, including any cost-sharing (including any deductible, copayment, or coinsurance) and, as determined by the Secretary, any other expenditure. ( July 1, 1944, ch. 373 , title XXVII, § 2729, as added Pub. L. 115–263, § 2 , Oct. 10, 2018 , 132 Stat. 3672 .)
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- 132 Stat. 3672
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