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Oregon Revised Statutes Insurance § 743A.063

Current as of January 01, 2023 | Updated by Findlaw Staff

(1) A prescription drug benefit program, or a prescription drug benefit offered under a health benefit plan as defined in ORS 743.730, must provide for reimbursement for up to a 90-day supply of a prescription drug dispensed by a pharmacy, as defined in ORS 689.005, if:

(a) The prescription drug is covered by the program or plan;

(b) An initial 30-day supply of the prescription drug has been previously dispensed to the program or plan member; and

(c) The quantity of the prescription drug dispensed does not exceed the total remaining quantity of the prescription drug that the prescribing practitioner authorized to be dispensed through refills.

(2) The coverage required by subsection (1) of this section may be limited by the terms and conditions of a pharmacy network contract, or a prescription drug benefit program or health benefit plan, that are related to the reimbursement rate of the prescription drug.

(3) The coverage required by subsection (1) of this section may be limited by formulary restrictions that are related to the prescription drug.

(4) This section does not apply to the reimbursement of prescription drugs classified as a controlled substance in Schedule II.

(5) This section is exempt from ORS 743A.001.

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Cite this article: FindLaw.com - Oregon Revised Statutes Insurance § 743A.063 - last updated January 01, 2023 | https://codes.findlaw.com/or/title-56-insurance/or-rev-st-sect-743a-063/

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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