Nebraska § 44-4614 - Choice of pharmacy services; prohibited acts.

§ 44-4614. Choice of pharmacy services; prohibited acts.

(1) A health benefit plan, health carrier, or pharmacy benefit manager shall not:

(a) Require a covered person, as a condition of payment or reimbursement, to obtain pharmacist services exclusively through the mail-order pharmacy or pharmacy benefit manager affiliate;

(b) Prohibit or limit a covered person from selecting a network pharmacist or network pharmacy of the covered person's choice;

(c) Transfer a covered person's prescriptions from a network pharmacy to another pharmacy unless requested by the covered person;

(d) Use financial incentives, including, but not limited to, adjustments in cost-sharing obligations of a covered person, to the exclusive benefit of the pharmacy benefit manager affiliate pharmacy; or

(e) Except as provided in subdivision (2)(b) of this section, auto-enroll a covered person in mail-order pharmacist services.

(2) Nothing in this section shall be construed to prevent a health benefit plan, health carrier, or pharmacy benefit manager from:

(a) Requiring a covered person to use a network specialty pharmacy;

(b) Auto-enrolling a covered person in mail-order pharmacist services for a maintenance medication, provided that a covered person:

(i) Shall not be auto-enrolled for the first ninety days of a new maintenance medication; and

(ii) Shall have the ability to opt out of mail-order pharmacist services at any time;

(c) Informing a covered person of an ability to obtain pharmacist services at a lower cost; or

(d) Requiring a covered person to obtain pharmacist services from a mail-order pharmacy or pharmacy benefit manager affiliate when such services are not otherwise available from another network pharmacy.