(1) Beginning January 1, 2021, the maximum amount a health carrier or pharmacy benefit manager may require a person to pay at the point of sale for a covered prescription medication is the lesser of:

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Terms Used In Washington Code 48.43.430

  • person: may be construed to include the United States, this state, or any state or territory, or any public or private corporation or limited liability company, as well as an individual. See Washington Code 1.16.080
(a) The applicable cost sharing for the prescription medication; or
(b) The amount the person would pay for the prescription medication if the person purchased the prescription medication without using a health plan.
(2) A health carrier or pharmacy benefit manager may not require a pharmacist to dispense a brand name prescription medication when a less expensive therapeutically equivalent generic prescription medication is available.
(3) For purposes of this section, “pharmacy benefit manager” has the same meaning as in *RCW 19.340.010.

NOTES:

*Reviser’s note: RCW 19.340.010 was repealed by 2020 c 240 § 19, effective January 1, 2022. For later enactment, see RCW 48.200.020.