(6) impose any limitation on the distance between the
covered entity and contract pharmacy; or
(7) except as necessary to comply with paragraph (1) or
section 256b of the Public Health Service Act, request,
require or compel the transmission of any ingredient cost,
pricing data or other data pertaining to the program
established under section 256b of the Public Health Service
Act.
Section 4. Prevention or interference with patient choice
prohibited.
If a patient is eligible to receive drugs under section 256b
of the Public Health Service Act from a covered entity or
contract pharmacy, a pharmacy benefits plan may not discriminate
against the covered entity or contract pharmacy in a manner that
prevents or interferes with the patient's choice to receive
drugs from the covered entity or contract pharmacy, including
cost-sharing differentials, drug formulary differences, refill
limitations or supply-day restrictions.
Section 5. Reimbursement claims methodology.
The department, a managed care organization or an entity that
administers or manages prescription drug benefits or that pays a
reimbursement to a provider that dispenses prescription drugs,
including an insurer, health benefit plan, self-insured plan or
workers' compensation insurance plan, on behalf of the
department or a managed care organization, shall rely
exclusively on a claims-level methodology involving the use of a
nationally recognized billing modifier or retrospective claims
identification process for identifying drugs purchased under
section 256b of the Public Health Service Act to ensure that
claims for the drugs are removed from the encounter data
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