33-2-2410. Federal 340B drug pricing program, MCA

Montana Code Annotated 2021

TITLE 33. INSURANCE AND INSURANCE COMPANIES

CHAPTER 2. REGULATION OF INSURANCE COMPANIES

Part 24. Pharmacy Benefit Manager Oversight

Federal 340b Drug Pricing Program

33-2-2410. Federal 340B drug pricing program. A pharmacy benefit manager or health carrier may not:

(1) prohibit a federally certified health entity or a pharmacy under contract with an entity to provide pharmacy services from participating in the pharmacy benefit manager's or health carrier's provider network;

(2) reimburse a federally certified health entity or a pharmacy under contract with an entity differently than it reimburses other similarly situated pharmacies;

(3) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the medicaid program provided for in Title 53, chapter 6, part 1; or

(4) create a restriction or an additional charge on a patient who chooses to receive drugs from a federally certified health entity or a pharmacy under contract with an entity, including but not limited to a patient's inability to fully pay a copayment. (Subsection (3) terminates June 1, 2023--sec. 26, Ch. 501, L. 2021.)

History: En. Sec. 10, Ch. 501, L. 2021.