Insurance Code § 1560.003

An issuer of a health benefit plan with pharmacy benefits must let enrollees get a 60-day-or-more prescription drug supply from a community retail pharmacy on the same terms as mail order pharmacy use, if the pharmacy accepts the same reimbursement terms.

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Jurisdiction: United States — Texas
Instrument: Code
Version: Undated source snapshot
Language: en
Official source: View official record ↗

community retail pharmacy mail order pharmacy pharmacy supply

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Provisions of Insurance Code § 1560.003

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1560.003
Insurance Code § 1560.003
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AI-assisted research summary: An issuer of a health benefit plan with pharmacy benefits must let enrollees get a 60-day-or-more prescription drug supply from a community retail pharmacy on the same terms as mail order pharmacy use, if the pharmacy accepts the same reimbursement terms.

Sec. 1560.003. MULTIPLE-MONTH SUPPLY OF PRESCRIPTION DRUG. (a) In this section, "multiple-month supply" means a supply for 60 or more days. (b) Notwithstanding any other law, an issuer of a health benefit plan that provides pharmacy benefits to enrollees must allow an enrollee to obtain from a community retail pharmacy a multiple-month supply of any prescription drug under the same terms and conditions applicable when the prescription drug is obtained from a mail order pharmacy, if the community retail pharmacy agrees to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy. (c) This section does not require: (1) the issuer of a health benefit plan to contract with: (A) a retail pharmacy that does not agree to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy; or (B) more than one mail order pharmacy; or (2) a community retail pharmacy to: (A) provide a multiple-month supply of a prescription drug under the same terms and conditions applicable when the prescription drug is obtained from a mail order pharmacy; or (B) agree to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy. Added by Acts 2009, 81st Leg., R.S., Ch. 1207 (S.B. 704), Sec. 5, eff. September 1, 2009.

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Insurance Code § 1560.003

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Provisions of Insurance Code § 1560.003

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