§ 4089j - Retail pharmacies; filling of prescriptions - Vermont Statutes

§ 4089j. Retail pharmacies; filling of prescriptions

(a) A health insurer and pharmacy benefit manager doing business in Vermont shall permit a retail pharmacist licensed under chapter 36 of Title 26 to fill prescriptions in the same manner and at the same level of reimbursement as they are filled by mail order pharmacies with respect to the quantity of drugs or days' supply of drugs dispensed under each prescription.

(b) As used in this section:

(1) "Health insurer" is defined by section 9402 of Title 18.

(2) "Pharmacy benefit manager" means an entity that performs pharmacy benefit management. "Pharmacy benefit management" means an arrangement for the procurement of prescription drugs at negotiated dispensing rates, the administration or management of prescription drug benefits provided by a health insurance plan for the benefit of beneficiaries, or any of the following services provided with regard to the administration of pharmacy benefits:

(A) mail service pharmacy;

(B) claims processing, retail network management, and payment of claims to pharmacies for prescription drugs dispensed to beneficiaries;

(C) clinical formulary development and management services;

(D) rebate contracting and administration;

(E) certain patient compliance, therapeutic intervention, and generic substitution programs; and

(F) disease management programs.

(c) This section shall apply to Medicaid, the Vermont health access plan, the VScript pharmaceutical assistance program, and any other public health care assistance program. (Added 2003, No. 122 (Adj. Sess.), § 128e.)