Montana Code Annotated 2023

TITLE 33. INSURANCE AND INSURANCE COMPANIES

CHAPTER 2. REGULATION OF INSURANCE COMPANIES

Part 24. Pharmacy Benefit Manager Oversight

Federal 340b Drug Pricing Program

33-2-2410. Federal 340B drug pricing program. A pharmacy benefit manager or health carrier may not:

(1) prohibit a federally certified health entity or a pharmacy under contract with an entity to provide pharmacy services from participating in the pharmacy benefit manager's or health carrier's provider network;

(2) reimburse a federally certified health entity or a pharmacy under contract with an entity differently than it reimburses other similarly situated pharmacies;

(3) require a claim for a drug to include a modifier to indicate that the drug is a 340B drug unless the claim is for payment, directly or indirectly, by the medicaid program provided for in Title 53, chapter 6, part 1; or

(4) create a restriction or an additional charge on a patient who chooses to receive drugs from a federally certified health entity or a pharmacy under contract with an entity, including but not limited to a patient's inability to fully pay a copayment. (Subsection (3) terminates June 1, 2025--sec. 1, Ch. 259, L. 2023.)

History: En. Sec. 10, Ch. 501, L. 2021.