***** 550.831.new THIS NEW SECTION IS EFFECTIVE JANUARY 1, 2024 *****
Sec. 21.
(1) A contract between a pharmacy benefit manager and a pharmacist or a pharmacy that provides drug coverage for health plans must not prohibit or restrict a pharmacy or pharmacist from, or penalize a pharmacy or pharmacist for, disclosing to a covered person or enrollee health care information that the pharmacy or pharmacist considers appropriate regarding any of the following:
(a) The nature of the treatment or the risks or the alternatives to the treatment.
(b) The availability of alternate therapies, consultations, or tests.
(2) A pharmacy benefit manager shall not prohibit a pharmacy or pharmacist from discussing information regarding the total cost for pharmacist services for a drug or from selling a more affordable alternative to the covered person or enrollee if a more affordable alternative is available.
(3) A carrier, health plan, or pharmacy benefit manager shall not require a covered person or enrollee to make a payment for a prescription drug at the point of sale in an amount greater than the lesser of the following:
(a) The applicable copayment, coinsurance, and deductible.
(b) The final reimbursement amount to the network pharmacy.
History: 2022, Act 11, Eff. Jan. 1, 2024
Structure Michigan Compiled Laws
Chapter 550 - General Insurance Laws
Act 11 of 2022 - Pharmacy Benefit Manager Licensure and Regulation Act (550.811.new - 550.845.new)
Section 550.811.new - Short Title.
Section 550.815.new - Definitions; a to I.
Section 550.817.new - Definitions; M to P.
Section 550.819.new - Definitions; R to W.
Section 550.823.new - Promulgation of Rules.
Section 550.829.new - Prohibited Conduct.
Section 550.837.new - Maximum Allowable Costs; Pharmacy Benefit Manager Duties.
Section 550.840.new - Enforcement of Act; Examination and Audit.
Section 550.841.new - Contract Compliance; License Requirement.