(a) A PBM, when seeking payment or reimbursement for pharmacist services provided in connection with a pharmacy benefits plan or program or reporting expenditures for pharmacist services provided in connection with a pharmacy benefits plan or program, shall itemize by individual claim:
(1) The amount actually paid or to be paid to the pharmacy or pharmacist for the pharmacist services;
(2) The identity of the pharmacy or pharmacist actually paid or to be paid; and
(3) The prescription number or other identifier of the pharmacist services.
(b) A PBM shall pay the amounts it receives for pharmacist services provided in connection with a pharmacy benefits plan or program to the pharmacies or pharmacists that provided the pharmacist services.
(c) This section does not:
(1) Require a PBM to set specific fees, rates, or schedules for payment for pharmacist services;
(2) Prohibit a PBM from charging for any services in addition to pharmacist services; or
(3) Require a PBM to pay a pharmacy or pharmacist more on any claim than the amount disclosed under subdivision (a)(1) of this section.
Section: Previous 4-88-802 4-88-803 4-88-804 NextLast modified: November 15, 2016