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Michigan Compiled Laws, Chapter 550. General Insurance Laws § 550.831

Current as of January 01, 2025 | Updated by Findlaw Staff

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.

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Cite this article: FindLaw.com - Michigan Compiled Laws, Chapter 550. General Insurance Laws § 550.831 - last updated January 01, 2025 | https://codes.findlaw.com/mi/chapter-550-general-insurance-laws/mi-comp-laws-550-831/

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