[§487J-7]  Pharmacy benefit managers;

health information; prohibited marketing practices.  (a)  A pharmacy

benefit manager shall not:

     (1)  Use an individual's health information, or share

an individual's health information with any pharmacy affiliated with or owned,

wholly or in part, by the pharmacy benefit manager, for the purpose of

marketing, unless:

         (A)  Use of the individual's health information

is medically necessary to the health and safety of the individual;

         (B)  Use of the individual's health information

is consistent with regulations of the federal Centers for Medicare and

Medicaid, if the plan is governed by those rules; or

         (C)  The individual has affirmatively opted in,

in writing, to use of the information;

     (2)  Sell or disseminate such information unless the

sale or dissemination complies with all federal and state laws and the pharmacy

benefit manager has received written approval for such sale or dissemination

from the employee benefit plan, health benefits plan, or managed care plan sponsor,

and the individual; or

     (3)  Directly contact an individual by any means,

including via electronic delivery, telephonic, SMS text, or direct mail, for

the purposes of marketing pharmacy benefit manager-owned pharmacies without the

express written permission of the employee benefit plan, health benefits plan,

or managed care plan sponsor, and the individual, unless the employee benefit

plan, health benefits plan, or managed care plan sponsor first determines that

the contact is medically necessary to the health and safety of the individual.

     (b)  Nothing in this section shall prohibit the

use of a patient's health information that is used in conjunction with an

insurer-authorized program to more effectively use prescription drugs to

improve the health and safety of the individual.

     (c)  A pharmacy benefit manager shall provide

each individual with an opportunity to affirmatively opt in to the sale or dissemination

of their health information prior to entering into any arrangement for the

lease, rental, dissemination, or sale of such information to any other entity,

or to any subsidiary owned, wholly or in part, by the pharmacy benefit manager;

provided that an individual may freely revoke the affirmative opt in at any

time. [L 2013, c 225, §2]

 

Note

 

  This section applies to all plans and contracts issued,

renewed, modified, altered, or amended on or after June 27, 2013.  L 2013, c

225, §5.

 

Revision Note

 

  In this section, "pharmacy benefit managers"

substituted for "pharmacy benefits managers", "pharmacy benefit

manager" substituted for "pharmacy benefits manager", and

"pharmacy benefit manager-owned pharmacies" substituted for

"pharmacy benefits manager-owned pharmacies".