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Texas Insurance Code - INS § 1560.003. Multiple-Month Supply of Prescription Drug

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) In this section, “multiple-month supply” means a supply for 60 or more days.

(b) Notwithstanding any other law, an issuer of a health benefit plan that provides pharmacy benefits to enrollees must allow an enrollee to obtain from a community retail pharmacy a multiple-month supply of any prescription drug under the same terms and conditions applicable when the prescription drug is obtained from a mail order pharmacy, if the community retail pharmacy agrees to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy.

(c) This section does not require:

(1) the issuer of a health benefit plan to contract with:

(A) a retail pharmacy that does not agree to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy;  or

(B) more than one mail order pharmacy;  or

(2) a community retail pharmacy to:

(A) provide a multiple-month supply of a prescription drug under the same terms and conditions applicable when the prescription drug is obtained from a mail order pharmacy;  or

(B) agree to accept reimbursement on exactly the same terms and conditions that apply to a mail order pharmacy.

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Cite this article: FindLaw.com - Texas Insurance Code - INS § 1560.003. Multiple-Month Supply of Prescription Drug - last updated January 01, 2024 | https://codes.findlaw.com/tx/insurance-code/ins-sect-1560-003/

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