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Code · Washington · Title 48 — Insurance · Chapter 48.200

RCW 48.200.310

295 words·~1 min read·/wa/title-48/chapter-48-200/48-200-310·

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(1)A pharmacy benefit manager may not:
(a)Reimburse a network pharmacy an amount less than the contract price between the pharmacy benefit manager and the insurer, third-party payor, or the prescription drug purchasing consortium the pharmacy benefit manager has contracted with;
(b)Require a covered person to pay more at the point of sale for a covered prescription drug than is required under RCW 48.43.430 ; or
(c)Require or coerce a patient to use their owned or affiliated pharmacies.
(2)A pharmacy benefit manager shall:
(a)Apply the same utilization review, fees, days allowance, and other conditions upon a covered person when the covered person obtains a prescription drug from a pharmacy that is included in the pharmacy benefit manager's pharmacy network, including mail order pharmacies;
(b)Permit the covered person to receive delivery or mail order of a prescription drug through any network pharmacy that is not primarily engaged in dispensing prescription drugs to patients through the mail or common carrier; and
(c)For new prescriptions issued after January 1, 2026, receive affirmative authorization from a covered person before filling prescriptions through a mail order pharmacy.
(3)If a covered person is using a mail order pharmacy, the pharmacy benefit manager shall:
(a)Allow for dispensing at local network pharmacies under the following circumstances to ensure patient access to prescription drugs:
(i)If the prescription is delayed more than one day after the expected delivery date provided by the mail order pharmacy; or
(ii)If the prescription drug arrives in an unusable condition; and
(b)Ensure patients have easy and timely access to prescription counseling by a pharmacist.
[ 2024 c 242 s 7 .]
Notes:
Effective date — 2024 c 242 ss 5 and 7-9: See note following RCW 48.200.280 .
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