§ 23-79-2503 — Implementation of subchapter - Requirements

(a) An enrollee's defined cost sharing for a prescription drug shall be calculated at the point-of-sale based on a price that is reduced by an amount equal to at least one hundred percent (100%) of all rebates received, or to be received, in connection with the dispensing or administration of the prescription drug. (b) This subchapter shall not preclude a healthcare insurer from decreasing an enrollee's defined cost sharing by an amount greater than that required under subsection (a) of this section. (c) In implementing the requirements of this section, the state shall only regulate a healthcare insurer to the extent permissible under applicable law. (d) (1) In complying with this section, a healthcare insurer or its agents shall not publish or otherwise reveal information regarding the actual amount of rebates a healthcare insurer receives on a product or therapeutic class of products, manufacturer, or pharmacy-specific basis. (2) The information described in subdivision (d)(1) of this section is: (A) Protected as a trade secret; (B) Considered proprietary and confidential under § 23-61-107(a)(4) and § 23-61-207 ; (C) Not subject to disclosure under the Freedom of Information Act of 1967, § 25-19-101 et seq.; and (D) Not to be disclosed: (i) Directly or indirectly; or (ii) In a manner that would: (a) Allow for the identification of an individual product, therapeutic class of products, or manufacturer; or (b) Have the potential to compromise the financial, competitive, or proprietary nature of the information. (3) A healthcare insurer shall impose the confidentiality protections of this section on any vendor or downstream third party that performs healthcare or administrative services on behalf of the healthcare insurer that may receive or have access to rebate information.

Legislative History

Added by Act 2023, No. 333,§ 1, eff. 8/1/2023.