The Vermont Statutes Online
Banking and Insurance
4089j. Retail pharmacies; filling of prescriptions
(a) A health
insurer and pharmacy benefit manager doing business in Vermont shall permit a
retail pharmacist licensed under 26 V.S.A. chapter 36 to fill prescriptions in
the same manner and at the same level of reimbursement as they are filled by
mail order pharmacies with respect to the quantity of drugs or days' supply of
drugs dispensed under each prescription.
(b) As used in
insurer" is defined by 18 V.S.A. § 9402.
benefit manager" means an entity that performs pharmacy benefit
management. "Pharmacy benefit management" means an arrangement for
the procurement of prescription drugs at negotiated dispensing rates, the
administration or management of prescription drug benefits provided by a health
insurance plan for the benefit of beneficiaries, or any of the following
services provided with regard to the administration of pharmacy benefits:
(A) mail service
processing, retail network management, and payment of claims to pharmacies for
prescription drugs dispensed to beneficiaries;
formulary development and management services;
contracting and administration;
patient compliance, therapeutic intervention, and generic substitution
(c) This section
shall apply to Medicaid and any other public health care assistance program.
(Added 2003, No. 122 (Adj. Sess.), § 128e; amended 2013, No. 79, § 9, eff. Jan.