Montana § 33-2-2410 Federal 340b Drug Pricing Program

Montana Statutes

§ 33-2-2410 — Federal 340b Drug Pricing Program

Montana·Title 33 INSURANCE AND INSURANCE COMPANIES·Ch. 2 REGULATION OF INSURANCE COMPANIES·Part 24 Pharmacy Benefit Manager Oversight

33-2-2410 . Federal 340B drug pricing program. A pharmacy benefit manager or health carrier may not:

(1)prohibit a federally certified health entity or a pharmacy under contract with an entity to provide pharmacy services from participating in the pharmacy benefit manager's or health carrier's provider network;

(2)reimburse a federally certified health entity or a pharmacy under contract with an entity differently than it reimburses other similarly situated pharmacies;

(3)require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the medicaid program provided for in Title 53, chapter 6, part 1; or

(4)create a restriction or an additional charge on a patient who chooses to receive drugs from a fed

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33-2-2410 . Federal 340B drug pricing program. A pharmacy benefit manager or health carrier may not:
(1) prohibit a federally certified health entity or a pharmacy under contract with an entity to provide pharmacy services from participating in the pharmacy benefit manager's or health carrier's provider network;
(2) reimburse a federally certified health entity or a pharmacy under contract with an entity differently than it reimburses other similarly situated pharmacies;
(3) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the medicaid program provided for in Title 53, chapter 6, part 1; or
(4) create a restriction or an additional charge on a patient who chooses to receive drugs from a federally certified health entity or a pharmacy under contract with an entity, including but not limited to a patient's inability to fully pay a copayment. (Subsection (3) terminates June 1, 2029--sec. 34, Ch. 8, L. 2025.)

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