™Your Policy Risk Impact Agent
23 chapters · 216 sections in this title.
40 Pa.C.S. § 4001 Definitions
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The following words and phrases when used in this chapter shall have the meanings given to them in this section unless the context clearly indicates otherwise: "Health insurance policy." An individual or group policy, subscriber contract, certificate or plan issued by an insurer …
40 Pa.C.S. § 4002 Prorated daily cost-sharing rate
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A health insurance policy shall permit and apply a prorated daily cost-sharing rate to maintenance medications that are dispensed by a pharmacy as a partial supply if the pharmacist or prescriber determines the fill or refill to be in the best interest of the patient and the pati…
40 Pa.C.S. § 4003 Denial of coverage
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(a) Partial supply.--A health insurance policy providing prescription drug coverage may not deny coverage for the dispensing of a maintenance medication that is dispensed by a network pharmacy on the basis that the dispensing is for a partial supply if the prescriber or pharmacis…
40 Pa.C.S. § 4004 Certain payment structures prohibited
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(a) Prorated dispensing fees.--A health insurance plan providing prescription drug coverage may not use payment structures incorporating prorated dispensing fees. (b) Full payment.--Dispensing fees for a partial supply or refilled prescriptions shall be paid in full for each main…
