Section 1610-T. Medical assistance pharmacy services.
(a) Authorization.--A pharmacy benefit manager or pharmacy services administration organization that has terminated a contract with or disenrolled a pharmacy for cause shall authorize the pharmacy to reapply to be included within the network where:
(1) 12 months have lapsed from the date of termination or disenrollment; and
(2) the pharmacy is qualified to participate and is enrolled in the Medical Assistance Program.
(b) Construction.--This section shall not be construed to require a pharmacy benefit manager or pharmacy services administration organization to contract with a pharmacist or pharmacy if the pharmacist or pharmacy was disenrolled or terminated for any of the following:
(1) A violation of section 1407 of the act of June 13, 1967 (P.L.31, No.21), known as the Human Services Code.
(2) A criminal violation of the act of April 14, 1972 (P.L.233, No.64), known as The Controlled Substance, Drug, Device and Cosmetic Act.
(3) A criminal violation of 21 U.S.C. § 841 (relating to prohibited acts A).
(4) A violation of a similar offense to paragraph (1) or (2) in another jurisdiction.
(c) Willing participant.--A qualified pharmacy under subsection (a) that was not terminated or disenrolled subject to violations in subsection (b) shall be deemed a willing provider and the managed care organization, its pharmacy benefit manager or pharmacy services administration organization shall contract with the qualified pharmacy that is willing to comply with payment rates and adhere to quality standards in accordance with section 449 of the Human Services Code.
(d) Definitions.--As used in this section, the following words and phrases shall have the meanings given to them in this subsection unless the context clearly indicates otherwise:
"Managed care organization." A licensed managed care organization with an agreement with the Department of Human Services to provide or arrange services to a Medical Assistance recipient.
"Pharmacy benefit manager." As defined in section 449 of the Human Services Code.
"Pharmacy services administration organization." As defined in section 449 of the Human Services Code.
(1610-T added July 12, 2026, P.L.265, No.21)