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§ 4003. Denial of coverage

Purdon's Pennsylvania Statutes and Consolidated StatutesTitle 40 Pa.C.S.A. InsuranceEffective: July 1, 2020

Purdon's Pennsylvania Statutes and Consolidated Statutes
Title 40 Pa.C.S.A. Insurance (Refs & Annos)
Part II. Regulation of Insurers and Related Persons Generally (Refs & Annos)
Chapter 40. Medication Synchronization
Effective: July 1, 2020
40 Pa.C.S.A. § 4003
§ 4003. Denial of coverage
(a) Partial supply.--A health insurance policy providing prescription drug coverage may not deny coverage for the dispensing of a maintenance medication that is dispensed by a network pharmacy on the basis that the dispensing is for a partial supply if the prescriber or pharmacist determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of medication synchronization.
(b) Denial codes.--The health insurance policy shall accept early refill and partial supply requests for maintenance medications dispensed for the purpose of medication synchronization using the submission clarification and message codes as adopted by the National Council for Prescription Drug Programs or alternative codes provided by the health insurance policy.
(c) Compliance.--Nothing in this chapter may prohibit a health insurance policy from using other methods to comply with this chapter.

Credits

2019, July 2, P.L. 333, No. 46, § 1, effective in 365 days [July 1, 2020].
40 Pa.C.S.A. § 4003, PA ST 40 Pa.C.S.A. § 4003
Current through Act 11 of the 2024 Regular Session. Some statute sections may be more current, see credits for details.
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