(1) Any health benefit plan, except supplemental policies covering a specified disease or other limited benefit, that provides hospital, surgical, or medical expense insurance may provide coverage for health care services under a specific treatment protocol provided by a pharmacist if:
The pharmacist meets the requirements in part 6 of article 280 of title 12;
The health benefit plan provides coverage for the same service provided by a licensed physician or an advanced practice nurse;
The pharmacist is included in the health benefit plan's network of participating providers; and
A reimbursement rate has been successfully negotiated in good faith between thepharmacist and the health plan.
(2) (a) A health benefit plan described in subsection (1) of this section shall provide coverage for health care services provided by a pharmacist within a health professional shortage area, as defined in 42 U.S.C. sec. 254e, if the conditions specified in subsection (1) of this section are met.
(b) This subsection (2) does not require a carrier to contract with a pharmacy or pharmacist willing to abide by the terms and conditions for participation established by the health benefit plan or carrier.
Source: L. 2016: Entire section added, (SB 16-135), ch. 239, p. 981, § 1, effective August 10. L. 2018: (2) added, (HB 18-1112), ch. 112, p. 806, § 1, effective August 8. L. 2019: (1)(a) amended, (HB 19-1172), ch. 136, p. 1657, § 52, effective October 1.