Tennessee Code 56-7-3203 – Disclosure of the actual reimbursement for a particular prescription or covered service
Current as of: 2023 | Check for updates
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Terms Used In Tennessee Code 56-7-3203
- Actual reimbursement: means the total amount that a covered entity or pharmacy benefits manager determines that a pharmacy or other dispenser will receive consistent with the provider agreement, and is the sum of the amount the covered entity or pharmacy benefits manager will pay directly to the pharmacy or other dispenser plus any applicable patient out-of-pocket cost paid directly by the patient to the pharmacy or other dispenser, for dispensing of a particular prescription or providing a covered service. See Tennessee Code 56-7-3201
- Contract: A legal written agreement that becomes binding when signed.
- Covered entity: means a covered entity as defined in §. See Tennessee Code 56-7-3201
- Pharmacy benefits manager: means a pharmacy benefits manager as defined in §. See Tennessee Code 56-7-3201
- Representative: when applied to those who represent a decedent, includes executors and administrators, unless the context implies heirs and distributees. See Tennessee Code 1-3-105
A covered entity or pharmacy benefits manager shall not in any way restrict, by contract or otherwise, any pharmacy or other dispenser from disclosing to the patient or authorized representative of the patient the actual reimbursement for a particular prescription or covered service. A pharmacy or other dispenser may disclose the actual reimbursement either orally or in writing on any document, including, but not limited to, a receipt, patient profile and summary of the patient’s expenditures for prescriptions or covered services.