Bill > HB1172

This bill expands patient choice for specialty pharmacy benefits, ensuring that individuals receiving covered specialty pharmacy benefits from a non-preferred or non-participating pharmacy, even if that pharmacy hasn't formally submitted a reimbursement agreement, will not be responsible for costs exceeding their standard copayment and the insurer's reimbursement rate for preferred or participating pharmacies. This provision applies to various types of insurance plans, including preferred provider policies, exclusive provider policies, and health maintenance organization plans, and aims to prevent patients from incurring unexpected out-of-pocket expenses when using pharmacies outside their insurer's preferred network for specialty medications.

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https://lis.virginia.gov/bill-details/20261/HB1172