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URL:http://alisondb.legislature.state.al.us/alison/CodeOfAlabama
/1975/27-45A-5.htm
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Modified:2020-01-07 11:12:08
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Title:27-45A-5
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Body:Section 27-45A-5

Disclosure of cost share information; discussion and sale of prescription drug alternatives; prohibited payment practices.

(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.

(Act 2019-457, ยง5.)