Expands pharmacy benefit management services to include durable medical equipment.
This bill expands pharmacy benefit management services to include the management or administration of benefits relating to durable medical equipment. It defines "durable medical equipment" and outlines rules for pharmacy or durable medical equipment provider audits by pharmacy benefit managers. Audits must provide advance notice, limit the number of prescriptions audited, and allow for documentation submission to address findings. The bill also mandates that pharmacy benefit managers furnish required data upon request and prohibits unreasonable delays in processing requests.
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- Core Provisions
- Implementation
- Impact
- Legal Framework
- Critical Issues
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