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Current as of January 01, 2024 | Updated by Findlaw Staff
(1) A health benefit plan, health carrier, or pharmacy benefit manager shall not:
(a) Require a covered person, as a condition of payment or reimbursement, to obtain pharmacist services exclusively through the mail-order pharmacy or pharmacy benefit manager affiliate;
(b) Prohibit or limit a covered person from selecting a network pharmacist or network pharmacy of the covered person's choice;
(c) Transfer a covered person's prescriptions from a network pharmacy to another pharmacy unless requested by the covered person;
(d) Use financial incentives, including, but not limited to, adjustments in cost-sharing obligations of a covered person, to the exclusive benefit of the pharmacy benefit manager affiliate pharmacy; or
(e) Except as provided in subdivision (2)(b) of this section, auto-enroll a covered person in mail-order pharmacist services.
(2) Nothing in this section shall be construed to prevent a health benefit plan, health carrier, or pharmacy benefit manager from:
(a) Requiring a covered person to use a network specialty pharmacy;
(b) Auto-enrolling a covered person in mail-order pharmacist services for a maintenance medication, provided that a covered person:
(i) Shall not be auto-enrolled for the first ninety days of a new maintenance medication; and
(ii) Shall have the ability to opt out of mail-order pharmacist services at any time;
(c) Informing a covered person of an ability to obtain pharmacist services at a lower cost; or
(d) Requiring a covered person to obtain pharmacist services from a mail-order pharmacy or pharmacy benefit manager affiliate when such services are not otherwise available from another network pharmacy.
Cite this article: FindLaw.com - Nebraska Revised Statutes Chapter 44. Insurance § 44-4614. Choice of pharmacy services; prohibited acts - last updated January 01, 2024 | https://codes.findlaw.com/ne/chapter-44-insurance/ne-rev-st-sect-44-4614/
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 before relying on it for your legal needs.
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