Terms Used In Kansas Statutes 40-3831

  • Act: means the pharmacy benefits manager licensure act. See Kansas Statutes 40-3822
  • Commissioner: means the commissioner of insurance of the state of Kansas. See Kansas Statutes 40-3801
  • Contract: A legal written agreement that becomes binding when signed.
  • Covered person: means a member, policyholder, subscriber, enrollee, beneficiary, dependent or other individual participating in a health benefit plan. See Kansas Statutes 40-3822
  • Person: means an individual or a business entity. See Kansas Statutes 40-3801
  • Pharmacy benefits manager: includes any person or entity acting in a contractual or employment relationship for a pharmacy benefits manager in the performance of pharmacy benefits management for a covered entity. See Kansas Statutes 40-3822

(a) This section shall be known and may be cited as the Kansas pharmacy patients fair practices act.

(b) As used in this section:

(1) “Covered person” means the same as defined in Kan. Stat. Ann. § 40-3822, and amendments thereto.

(2) “Health carrier” means the same as defined in Kan. Stat. Ann. § 40-2,195, and amendments thereto.

(3) “Pharmacy benefits manager” means the same as defined in Kan. Stat. Ann. § 40-3822, and amendments thereto.

(c) (1) Co-payments applied by a health carrier for a prescription drug may not exceed the total submitted charges by the network pharmacy.

(2) A pharmacy or pharmacist shall have the right to provide a covered person with information regarding the amount of the covered person‘s cost share for a prescription drug. Neither a pharmacy nor a pharmacist shall be proscribed by a pharmacy benefits manager from discussing any such information or for selling a more affordable alternative to the covered person if such an alternative is available.

(d) (1) This section applies to any contract between a pharmacy benefits manager and a pharmacy, a pharmacy services administration organization or a group purchasing organization that is entered into or renewed on and after January 1, 2019.

(2) The provisions of this section shall not apply to any policy or certificate that provides coverage for any specified disease, specified accident or accident only coverage, credit, dental, disability income, hospital indemnity, long-term care insurance as defined by Kan. Stat. Ann. § 40-2227, and amendments thereto, vision care or any other limited supplemental benefit nor to any medicare supplement policy of insurance as defined by the commissioner of insurance by rule and regulation, any coverage issued as a supplement to liability insurance, workers compensation or similar insurance, automobile medical-payment insurance or any insurance under which benefits are payable with or without regard to fault, whether written on a group, blanket or individual basis.