Statute · California Health and Safety Code
Cal. Health & Safety Code § 1367.42 — Standards
Cal. Health & Safety Code § 1367.42
- Type
- Statute
- Source
- California Health and Safety Code
- Jurisdiction
- California
- Date
- 2016-01-01
- Current through
- Nov 2, 2026 (California Legislative Counsel)
(a) For plan years commencing on or after January 1, 2017, a plan that provides essential health benefits shall allow an enrollee to access prescription drug benefits at an in-network retail pharmacy unless the prescription drug is subject to restricted distribution by the United States Food and…
Citator
Cal. Health & Safety Code § 1367.42 — Standards is in force in the current edition of the Code, and nothing recorded condemns it.
(a) For plan years commencing on or after January 1, 2017, a plan that provides essential health benefits shall allow an enrollee to access prescription drug benefits at an in-network retail pharmacy unless the prescription drug is subject to restricted distribution by the United States Food and Drug Administration or requires special handling, provider coordination, or patient education that cannot be provided by a retail pharmacy.
(b) A nongrandfathered individual or small group health plan contract may charge an enrollee a different cost sharing for obtaining a covered drug at a retail pharmacy, but all cost sharing shall count toward the plan’s annual limitation on cost sharing consistent with Section 1367.006.