510B.6 - DISPENSING OF SUBSTITUTE PRESCRIPTION DRUG FOR PRESCRIBED DRUG.

        510B.6  DISPENSING OF SUBSTITUTE PRESCRIPTION DRUG FOR      PRESCRIBED DRUG.         1.  The following provisions shall apply when a pharmacy benefits      manager requests the dispensing of a substitute prescription drug for      a prescribed drug to a covered individual:         a.  The pharmacy benefits manager may request the substitution      of a lower priced generic and therapeutically equivalent drug for a      higher priced prescribed drug.         b.  If the substitute drug's net cost to the covered      individual or covered entity exceeds the cost of the prescribed drug,      the substitution shall be made only for medical reasons that benefit      the covered individual.         2.  A pharmacy benefits manager shall obtain the approval of the      prescribing practitioner prior to requesting any substitution under      this section.         3.  A pharmacy benefits manager shall not substitute an equivalent      prescription drug contrary to a prescription drug order that      prohibits a substitution.  
         Section History: Recent Form
         2007 Acts, ch 193, §6, 9