Welcome to FindLaw's Cases & Codes, a free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.
(a) General rule.--In order to place a particular drug on a multiple source generic list, a PBM shall, at a minimum, ensure that:
(1) the drug is listed as “A” or “B” rated in the most recent version of the Food and Drug Administration's “Approved Drug Products with Therapeutic Equivalence Evaluations,” commonly known as the orange book, or “NR” or “NA” rated, or similar rating, by a nationally recognized reference;
(2) There are at least two therapeutically equivalent multiple source drugs or at least one generic drug available from only one manufacturer; and
(3) the drug is available for purchase by all pharmacies in this Commonwealth from national or regional wholesalers and is not obsolete or temporarily unavailable.
(b) Removal from listing.--A PBM must maintain a procedure to eliminate drugs from the list of drugs subject to multiple source drug pricing or modify the maximum allowable cost in a timely fashion.
(c) Substitutions.--A PBM may not penalize a pharmacist or pharmacy on audit if the pharmacist or pharmacy performs a generic substitution pursuant to the act of November 24, 1976 (P.L. 1163, No. 259), 1 referred to as the Generic Equivalent Drug Law.
Cite this article: FindLaw.com - Pennsylvania Statutes Title 40 P.S. Insurance § 4531. Multiple source generic list and reimbursement - last updated January 01, 2019 | https://codes.findlaw.com/pa/title-40-ps-insurance/pa-st-sect-40-4531.html
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.
Was this helpful?