Arkansas § 23-92-604 Third party and pharmaceutical manufacturer - Prohibitions

Arkansas Statutes

§ 23-92-604 — Third party and pharmaceutical manufacturer - Prohibitions

(a)A third party shall not:

(1)Coerce a patient into using a mail-order pharmacy;

(2)Require a patient to use a mail-order pharmacy;

(3)Discriminate, lower the reimbursement, or impose any separate terms upon a pharmacy in any other third party contract on the basis that a pharmacy participates in 340B drug pricing;

(4)Require a pharmacy to reverse, resubmit, or clarify a 340B drug-pricing claim after the initial adjudication unless these actions are in the normal course of pharmacy business and not related to 340B drug pricing;

(5)Require a billing modifier to indicate that the drug or claim is a 340B drug-pricing claim unless the drug or claim is being billed to the fee-for-service Arkansas Medicaid Program;

(6)Modify a patient's copayment on the basis of a pharmacy's participatio

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(a) A third party shall not: (1) Coerce a patient into using a mail-order pharmacy; (2) Require a patient to use a mail-order pharmacy; (3) Discriminate, lower the reimbursement, or impose any separate terms upon a pharmacy in any other third party contract on the basis that a pharmacy participates in 340B drug pricing; (4) Require a pharmacy to reverse, resubmit, or clarify a 340B drug-pricing claim after the initial adjudication unless these actions are in the normal course of pharmacy business and not related to 340B drug pricing; (5) Require a billing modifier to indicate that the drug or claim is a 340B drug-pricing claim unless the drug or claim is being billed to the fee-for-service Arkansas Medicaid Program; (6) Modify a patient's copayment on the basis of a pharmacy's participation in 340B drug pricing; (7) Exclude a pharmacy from a network on the basis of the pharmacy's participation in 340B drug pricing; (8) Establish or set network adequacy requirements based on 340B drug pricing participation by a provider or a pharmacy; or (9) Prohibit an entity authorized to participate in 340B drug pricing or a pharmacy under contract with an entity authorized to participate in 340B drug pricing from participating in the third party's provider network on the basis of participation in 340B drug pricing. (b) A third party that is a pharmacy benefits manager shall not base the drug formulary or drug coverage decisions upon the 340B drug-pricing status of a drug, including price or availability, or whether a dispensing pharmacy participates in 340B drug pricing. (c) A pharmaceutical manufacturer shall not: (1) Prohibit a pharmacy from contracting or participating with an entity authorized to participate in 340B drug pricing by denying access to drugs that are manufactured by the pharmaceutical manufacturer; or (2) Deny or prohibit 340B drug pricing for an Arkansas-based community pharmacy that receives drugs purchased under a 340B drug pricing contract pharmacy arrangement with an entity authorized to participate in 340B drug pricing.

Arkansas § 23-92-604 (Third party and pharmaceutical manufacturer - Prohibitions) — published by Counsel Stack Legal Research, free access to 12M+ legal documents.