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Current as of January 02, 2024 | Updated by Findlaw Staff
(a) A health insurance issuer, managed health insurance issuer as defined in § 56-32-128(a), pharmacy benefits manager, or other third-party payer shall not:
(1) Reimburse a 340B entity for pharmacy-dispensed drugs at a rate lower than the rate paid for the same drug by national drug code number to pharmacies that are not 340B entities;
(2) Assess a fee, chargeback, or adjustment upon a 340B entity that is not equally assessed on non-340B entities;
(3) Exclude 340B entities from its network of participating pharmacies based on criteria that is not applied to non-340B entities; or
(4) Require a claim for a drug by national drug code number to include a modifier to identify that the drug is a 340B drug.
(b) With respect to a patient eligible to receive drugs subject to an agreement under 42 U.S.C. § 256b, a pharmacy benefits manager, or third party that makes payment for those drugs, shall not discriminate against a 340B entity in a manner that violates § 56-7-2359 or otherwise prevents or interferes with the patient's choice to receive those drugs from the 340B entity.
(c) Notwithstanding § 56-7-1005, this section does not apply to:
(1) The TennCare program administered under the Medical Assistance Act of 1968, compiled in title 71, chapter 5, part 1, or a successor Medicaid program;
(2) The CoverKids Act of 2006, compiled in title 71, chapter 3, part 11, or a successor program; or
(3) The prescription drug program described in chapter 57 of this title, or a successor program.
(d) As used in this section:
(1) “340B entity” means a covered entity participating in the federal 340B drug discount program, as defined in section 340B of the Public Health Service Act, 42 U.S.C. § 256b, including the entity's pharmacy or pharmacies, or any pharmacy or pharmacies under contract with the 340B covered entity to dispense drugs on behalf of the 340B covered entity; and
(2) “National drug code number” means the unique national drug code number that identifies a specific approved drug, its manufacturer, and its package presentation.
Cite this article: FindLaw.com - Tennessee Code Title 56. Insurance § 56-7-3119 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-3119/
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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