Freedom of choice for pharmacy services.

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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.


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