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Current as of April 27, 2021 | Updated by FindLaw Staff
(1) In any participation contracts between a pharmacy benefit manager and pharmacies, pharmacists, or pharmacy services administrative organizations, a pharmacy or pharmacist may not be prohibited, restricted, or penalized in any way from disclosing to any enrollee or injured worker any information the pharmacy or pharmacist considers appropriate regarding:
(a) the decision of utilization reviewers or similar persons to authorize or deny drug coverage or benefits; and
(b) the process that is used to authorize or deny drug coverage or benefits.
(2)(a) A pharmacy benefit manager contract with a participating pharmacy, pharmacist, or a pharmacy services administrative organization in this state may not prohibit, restrict, or limit disclosure of information to the commissioner when the commissioner is investigating or examining a complaint or conducting a review of a pharmacy benefit manager's compliance with the requirements of this part.
(b) A pharmacy benefit manager may not terminate the contract of or penalize a pharmacy, pharmacist, or a pharmacy services administrative organization for sharing any portion of the pharmacy benefit manager contract with the commissioner for investigation of a complaint or a question regarding whether the contract complies with this part.
(c) Any examination or review under this section must follow the examination procedures and requirements applicable to insurers under Title 33, chapter 1, part 4, including but not limited to the confidentiality provisions of 33-1-409.
Cite this article: FindLaw.com - Montana Title 33. Insurance and Insurance Companies § 33-2-2404. Pharmacy benefit manager prohibited practices - last updated April 27, 2021 | https://codes.findlaw.com/mt/title-33-insurance-and-insurance-companies/mt-code-ann-sect-33-2-2404/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
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