Pennsylvania Statutes

§ 4004 — Certain payment structures prohibited

Pennsylvania·Title 40 INSURANCE·Part PART II·Ch. 40 MEDICATION SYNCHRONIZATION
(a)Prorated dispensing fees.--A health insurance plan providing prescription drug coverage may not use payment structures incorporating prorated dispensing fees.
(b)Full payment.--Dispensing fees for a partial supply or refilled prescriptions shall be paid in full for each maintenance medication dispensed, regardless of any prorated copay for the beneficiary or fee paid for alignment services.

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