§ 15-1636. Cancellation and reversal

   (a) In general. -- A pharmacy benefits manager or its agent shall cancel and reverse a therapeutic interchange on written or verbal instructions from a prescriber, the beneficiary, or the beneficiary's representative.

(b) Required actions on reversal. -- If a therapeutic interchange is reversed, the pharmacy benefits manager or its agent shall:

   (1) obtain a prescription for and dispense the originally prescribed prescription drug; and

   (2) charge the beneficiary no more than one copayment.

(c) Replacement prescription. -- If the therapeutic interchange occurred through a mail order pharmacy and a beneficiary will exhaust an existing supply of the originally prescribed prescription drug before a replacement shipment will arrive to the beneficiary, the pharmacy benefits manager or its agent shall arrange for dispensing of an appropriate quantity of replacement prescription drugs at a local community pharmacy at no additional cost to the beneficiary.

(d) When cancellation and reversal not required. -- A pharmacy benefits manager or its agent may not be required to cancel and reverse a therapeutic interchange if a beneficiary is unwilling to pay a higher copayment or coinsurance associated with the originally prescribed prescription drug.

HISTORY: 2008, ch. 36, § 6; chs. 203, 204.