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Co-Authored-By: Claude Opus 4.8 <noreply@anthropic.com>
2026-07-06 10:51:44 -04:00

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LegalText 42 U.S.C. § 300gg19b Information on prescription drugs us united_states_code code_section 42 THE PUBLIC HEALTH AND WELFARE 6A PUBLIC HEALTH SERVICE 300gg19b 42 U.S.C. § 300gg19b current 119-100 2026-06-26 official https://uscode.house.gov/download/releasepoints/us/pl/119/100/xml_usc42@119-100.zip /us/usc/t42/s300gg19b data/legal/raw/us/code/title-42/usc42.xml 899acf5eb5a4a8a4d32651b7a5b8ec275e88cbabd0982d213005e19657fb7b3e 644321055a08eb1f260a6a3e31ac157fa024756abf612a9fd6857e7e400cf24e dc6c827eacffb37b66a165e0cfa06abd6d88ca0969d39813ffbed1381fd4b4e0 2026-07-04 official
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42 U.S.C. § 300gg19b - Information on prescription drugs

Text

(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 enrollees 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 enrollees 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.

(July 1, 1944, ch. 373, title XXVII, § 2729, as added Pub. L. 115263, § 2, Oct. 10, 2018, 132 Stat. 3672.)