(a) A pharmacy or pharmacist may provide a covered person with information regarding the amount of the covered person's cost share for a prescription drug. Neither a pharmacy nor a pharmacist shall be proscribed by a pharmacy benefits manager from discussing any such information or for selling a more affordable alternative to the covered person if such an alternative is available.
(b) A health benefit plan that covers prescription drugs may not include a provision that requires an enrollee to make a payment for a prescription drug at the point of sale in an amount that exceeds the lessor of: (1) the contracted co-payment amount; or (2) the amount an individual would pay for a prescription if that individual were paying with cash.
(c) For purposes of this section, the following words have the following meanings:
(1) COVERED PERSON. Any individual, family, or family member on whose behalf third-party payment or prepayment of health or medical expenses is provided under a health benefit plan.
(2) ENROLLEE. A person named on a policy or certificate of coverage under a health benefit plan.
(3) HEALTH BENEFIT PLAN. As defined in Section 27-54A-2.
Last modified: May 3, 2021