31A-46-309. Reimbursement -- Prohibitions.
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Effective 5/12/2020
31A-46-309. Reimbursement -- Prohibitions.
(1)This section applies to a contract entered into or renewed on or after January 1, 2021, between a pharmacy benefit manager and a pharmacy.
(2)A pharmacy benefit manager may not vary the amount it reimburses a pharmacy for a drug on the basis of whether:
(a)the drug is a 340B drug; or
(b)the pharmacy is a 340B entity.
(3)Subsection
(2)does not apply to a drug reimbursed, directly or indirectly, by the Medicaid program.
(4)A pharmacy benefit manager may not:
(a)on the basis that a 340B entity participates, directly or indirectly, in the 340B drug discount program:
(i)assess a fee, charge-back, or other adjustment on the 340B entity;
(ii)restrict access to the pharmacy benefit manager's pharmacy network;
(iii)require the 340B entity to enter into a contract with a specific pharmacy to participate in the pharmacy benefit manager's pharmacy network;
(iv)create a restriction or an additional charge on a patient who chooses to receive drugs from a 340B entity; or
(v)create any additional requirements or restrictions on the 340B entity; or
(b)require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the Medicaid program.
Enacted by Chapter 275 , 2020 General Session
Technically renumbered to avoid duplication of section number also enacted in HB272, Chapter 198.