§ 31A-46-309 — Reimbursement -- Prohibitions.

(1) This section applies to a contract entered into or renewed on or after January 1, 2021, between a pharmacy benefit manager and a pharmacy.
(2) A pharmacy benefit manager may not vary the amount it reimburses a pharmacy for a drug on the basis of whether:

(2)(a) the drug is a 340B drug; or
(2)(b) the pharmacy is a 340B entity.
(3) Subsection (2) does not apply to a drug reimbursed, directly or indirectly, by the Medicaid program.
(4) A pharmacy benefit manager may not:

(4)(a) on the basis that a 340B entity participates, directly or indirectly, in the 340B drug discount program:
(4)(a)(i) assess a fee, charge-back, or other adjustment on the 340B entity;
(4)(a)(ii) restrict access to the pharmacy benefit manager's pharmacy network;
(4)(a)(iii) require the 340B entity to enter into a contract with a specific pharmacy to participate in the pharmacy benefit manager's pharmacy network;
(4)(a)(iv) create a restriction or an additional charge on a patient who chooses to receive drugs from a 340B entity; or
(4)(a)(v) create any additional requirements or restrictions on the 340B entity; or
(4)(b) 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.

Legislative History

Enacted by Chapter 275, 2020 General Session