H 5038 – South Carolina

Status: Enacted
Year Introduced: 2018
Year Enacted: 2018
Link: http://www.scstatehouse.gov/billsearch.php?billnumbers=5038&session=122&summary=B

PHARMACY BENEFIT MANAGER: Would prohibit a pharmacy benefits manager from prohibiting or penalizing a pharmacy or pharmacist from informing the patient of a lower cost including the cash price. A pharmacy benefit manager may not charge or collect a copayment from an insured that exceeds the total submitted charges by the network pharmacy.  A pharmacist or pharmacy may not be penalized by a pharmacy benefit manager for discussing such information to an insured or for selling a more affordable alternative to the insured if one is available. Would prohibit pharmacy benefit manager from reducing reimbursement after a claim has been adjudicated or charge or hold a pharmacist or pharmacy responsible for any fee that is related to a claim unless the fee is reported on the remittance advice of the adjudicated claim or is set out in contract between the pharmacy benefits manager and the pharmacy.

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