Pub. L. 78-373, tit. XXVII, pt. A, subpt. II, sec. 2729 (as amended)
INFORMATION ON PRESCRIPTION DRUGS.
SEC. 2729. INFORMATION ON PRESCRIPTION DRUGS.
(a) In General.—A group health
plan or a health insurance issuer offering group or individual
health insurance coverage shall—
(1) not restrict, directly or indirectly, any
pharmacy that dispenses a prescription drug to an enrollee in the plan or
coverage
from informing (or penalize such pharmacy for informing) an enrollee of
any differential between the enrollee's out-of-pocket cost under the
plan or coverage with respect to acquisition of the drug and the amount
an individual
would pay for acquisition of the drug without using any health plan or
health insurance
coverage; and
(2) ensure that any entity that provides pharmacy benefits management services under a contract
with any such
health plan
or health insurance coverage does not, with respect to such plan or
coverage,
restrict, directly or indirectly, a pharmacy that
dispenses a prescription drug from informing (or penalize such pharmacy
for informing) an
enrollee of any differential between the enrollee's out-of-pocket cost
under the plan or coverage with respect to acquisition of the drug and the
amount
an individual
would pay for acquisition of the drug without using any health plan or
health insurance
coverage.
(b) Definition.—For purposes of this section, the term “out-of-pocket cost”, with respect to acquisition of a drug, means the amount to be paid by the enrollee under the plan
or coverage, including any cost-sharing (including any deductible,
copayment, or coinsurance) and, as determined by the Secretary, any other
expenditure.