58-18-37 Freedom of choice for pharmacy services.
58-18-37.
Freedom of choice for pharmacy services.
No policy of group health insurance
providing benefits for hospital and medical expenses delivered in this state that is offered by a
commercial health insurance company, by a nonprofit medical and surgical plan corporation, by a
nonprofit hospital service plan corporation, by a health maintenance organization, by a preferred
provider organization, by an individual practice association or by a similar mechanism may:
(1)
Deny any licensed pharmacy or licensed pharmacist as defined in § 36-11-2 the right to
participate as a participating provider for any policy or plan on the same terms and
conditions as are offered to any other provider of pharmacy services under the policy or
plan;
(2)
Prevent any person who is a party to or beneficiary of any health insurance policy from
selecting a licensed pharmacy of his choice to furnish the pharmaceutical services offered
under any policy or plan, provided that the pharmacy is a participating provider under the
same terms and conditions of the policy or plan as those offered to any other provider of
pharmacy services; or
(3)
Permit or mandate any difference in coverage for or impose any different conditions,
including copayment fees, whether the prescription benefits are provided through direct
contact with a pharmacy or by use of an out-of-state mail order service so long as the
provider selected is a participant in the plan involved.
Source: SL 1990, ch 395, § 1.
Chapter 58-18