(a) A health insurance issuer, managed health insurance issuer as defined in § 56-32-128(a), pharmacy benefits manager, or other third-party payer shall not:

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Terms Used In Tennessee Code 56-7-3119

  • Code: includes the Tennessee Code and all amendments and revisions to the code and all additions and supplements to the code. See Tennessee Code 1-3-105
  • Contract: A legal written agreement that becomes binding when signed.
  • Pharmacy benefits manager: includes , but is not limited to, a health insurance issuer, managed health insurance issuer as defined in §. See Tennessee Code 56-7-3102
(1) Reimburse a 340B entity for pharmacy-dispensed drugs at a rate lower than the rate paid for the same drug by national drug code number to pharmacies that are not 340B entities;
(2) Assess a fee, chargeback, or adjustment upon a 340B entity that is not equally assessed on non-340B entities;
(3) Exclude 340B entities from its network of participating pharmacies based on criteria that is not applied to non-340B entities; or
(4) Require a claim for a drug by national drug code number to include a modifier to identify that the drug is a 340B drug.
(b) With respect to a patient eligible to receive drugs subject to an agreement under 42 U.S.C. § 256b, a pharmacy benefits manager, or third party that makes payment for those drugs, shall not discriminate against a 340B entity in a manner that violates § 56-7-2359 or otherwise prevents or interferes with the patient’s choice to receive those drugs from the 340B entity.
(c) Notwithstanding § 56-7-1005, this section does not apply to:

(1) The TennCare program administered under the Medical Assistance Act of 1968, compiled in title 71, chapter 5, part 1, or a successor Medicaid program;
(2) The CoverKids Act of 2006, compiled in title 71, chapter 3, part 11, or a successor program; or
(3) The prescription drug program described in chapter 57 of this title, or a successor program.
(d) As used in this section:

(1) “340B entity” means a covered entity participating in the federal 340B drug discount program, as defined in section 340B of the Public Health Service Act, 42 U.S.C. § 256b, including the entity’s pharmacy or pharmacies, or any pharmacy or pharmacies under contract with the 340B covered entity to dispense drugs on behalf of the 340B covered entity; and
(2) “National drug code number” means the unique national drug code number that identifies a specific approved drug, its manufacturer, and its package presentation.
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