40 Pa. Stat. § 4527

Current through Pa Acts 2024-53, 2024-56 through 2024-111
Section 4527 - Clawbacks prohibited
(a) General rule.--A pharmacist, pharmacy intern or technician may not charge a patient an amount for a covered prescription drug that exceeds the lesser of:
(1) The net reimbursement paid to the pharmacy for the prescription drug by the health benefit plan, health insurer or PBM contracting with a health benefit plan or health insurer.
(2) The amount an individual would pay for the prescription drug if the prescription drug were purchased without coverage under a health benefit plan.
(b)Collection of difference in cost sharing.--A health benefit plan, health insurer or PBM contracting with a health benefit plan or health insurer may not collect from the member any difference in cost sharing the member pays to the pharmacy and the member's cost sharing defined in the member's benefit plan.

40 P.S. § 4527

Added by P.L. (number not assigned at time of publication) 2024 No. 77,§ 6, eff. 11/14/2024.