A covered entity or pharmacy benefits manager shall disclose to a pharmacy or pharmacist in its network, at least thirty (30) days before the date the change becomes effective, any material change to a contract provision that affects the terms of reimbursement, the process for verifying benefits and eligibility, the dispute resolution procedure, the procedure for verifying drugs included in the formulary, and the procedure for contract termination. Nothing in this section prohibits a covered entity or pharmacy benefits manager from taking action without notice against a pharmacy or pharmacist in its network for a fraudulent claim or service.
Structure 2021 Tennessee Code
Chapter 7 - Policies and Policyholders
Part 31 - Pharmacy Benefits Managers
§ 56-7-3105. Contract Compliance
§ 56-7-3109. Medical Products and Devices Subject to Requirements of Part
§ 56-7-3110. Sanctions for Violation of Part
§ 56-7-3111. Disclosure of Maximum Allowable Cost Lists and Related Information
§ 56-7-3115. Prohibited Charges
§ 56-7-3116. Prohibited Terms or Conditions in Contracts
§ 56-7-3117. Disclosure of Material Changes to Contract Provisions