Montana Code 33-2-2409. Network adequacy
33-2-2409. Network adequacy. (1) A pharmacy benefit manager shall provide an adequate and accessible pharmacy network for the provision of prescription drugs to ensure reasonable proximity of pharmacies to the businesses or personal residences of enrollees and injured workers.
Terms Used In Montana Code 33-2-2409
- Pharmacy: means an established location, either physical or electronic, that is licensed by the board of pharmacy pursuant to Title 37, chapter 7. See Montana Code 33-2-2402
- Pharmacy benefit manager: means a person, including a wholly or partially owned or controlled subsidiary of a pharmacy benefit manager, that provides claims processing services or other prescription drug or device services, or both, to:
(i)enrollees who are residents of this state, for health benefit plans; or
(ii)injured workers of workers' compensation insurance carriers. See Montana Code 33-2-2402
(2)In determining whether a pharmacy benefit manager has complied with the requirements of this section, consideration must be given to the relative availability of physical pharmacies in a geographic area.
(3)The commissioner shall adopt rules for network adequacy.