View all text of Subpart II [§ 300gg-11 - § 300gg-19b]
§ 300gg–19b. Information on prescription drugs
(a) In general
A group health plan or a health insurance issuer offering group or individual health insurance coverage shall—
(1) not restrict, directly or indirectly, any pharmacy that dispenses a prescription drug to an enrollee in the plan or coverage from informing (or penalize such pharmacy for informing) an enrollee of any differential between the enrollee’s out-of-pocket cost under the plan or coverage with respect to acquisition of the drug and the amount an individual would pay for acquisition of the drug without using any health plan or health insurance coverage; and
(2) ensure that any entity that provides pharmacy benefits management services under a contract with any such health plan or health insurance coverage does not, with respect to such plan or coverage, restrict, directly or indirectly, a pharmacy that dispenses a prescription drug from informing (or penalize such pharmacy for informing) an enrollee of any differential between the enrollee’s out-of-pocket cost under the plan or coverage with respect to acquisition of the drug and the amount an individual would pay for acquisition of the drug without using any health plan or health insurance coverage.
(b) Definition
(July 1, 1944, ch. 373, title XXVII, § 2729, as added Pub. L. 115–263, § 2, Oct. 10, 2018, 132 Stat. 3672.)