LD 554
pg. 3
Page 2 of 5 An Act To Protect Against Unfair Prescription Drug Practices Page 4 of 5
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LR 1315
Item 1

 
entity in writing of any activity, policy or practice of
the pharmacy benefits manager that directly or indirectly
presents any conflict of interest with the duties imposed
by this subsection.

 
D.__A pharmacy benefits manager shall provide to a covered
entity all financial and utilization information requested
by the covered entity relating to the provision of
benefits to covered individuals through that covered
entity and all financial and utilization information
relating to services to that covered entity.__A pharmacy
benefits manager providing information under this
paragraph may designate that material as confidential.
Information designated as confidential by a pharmacy
benefits manager and provided to a covered entity under
this paragraph may not be disclosed to any person without
the consent of the pharmacy benefits manager, except that
disclosure may be made in a court filing under the Maine
Unfair Trade Practices Act or when authorized by that Act
or ordered by a court of this State for good cause shown.

 
E.__With regard to the dispensation of a substitute
prescription drug for a prescribed drug to a covered
individual the following provisions apply.

 
(1)__The pharmacy benefits manager may substitute a
lower-priced generic drug for a higher-priced
prescribed drug.

 
(2)__The pharmacy benefits manager may not substitute
a higher-priced generic drug for a lower-priced
prescribed drug.

 
(3)__The pharmacy benefits manager shall consult with
the prescribing health professional or that person's
authorized representative and shall:

 
(a) Disclose the costs of both drugs to the
covered individual and the covered entity and
any benefit or payment directly or indirectly
accruing to the pharmacy benefits manager as a
result of the substitution; and

 
(b) Obtain the approval of the prescribing
health professional or that person's authorized
representative for the substitution.

 
(4)__The pharmacy benefits manager shall transfer in full to
the covered entity or covered individuals any benefit or
payment received in any form by the pharmacy


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