Section 34-23-110 – Short Title.

Section 34-23-110 Short title. This article shall be known and may be cited as the “Third Party Prescription Program Act.” (Acts 1981, No. 81-337, p. 477, §1.)

Section 34-23-111 – “Third Party Prescription Program” Defined.

Section 34-23-111 “Third Party Prescription Program” defined. As used in this article, the term “Third Party Prescription Program” shall mean any system of providing for the reimbursement of pharmaceutical services under a contractual arrangement or agreement between a provider of such services and another party who is not the consumer of those services. Such programs […]

Section 34-23-112 – Required Contractual Provisions.

Section 34-23-112 Required contractual provisions. Any agreement or contract entered into in this state between the program administrator of a third party program and a pharmacy shall include a statement of the method and amount of reimbursement to the pharmacy for services rendered to persons enrolled in the program, the frequency of payment by the […]

Section 34-23-113 – Cancellation of Program; Use of Identity Card After Cancellation.

Section 34-23-113 Cancellation of program; use of identity card after cancellation. (a) The administrator of a program shall notify all pharmacies enrolled in the program of any cancellation of coverage of benefits of any group enrolled in the program at least 30 days prior to the effective date of such cancellation. (b) All persons enrolled […]

Section 34-23-114 – Denial of Payment.

Section 34-23-114 Denial of payment. (a) No program administrator shall deny payment for services to any pharmacy which may have resulted from the fraudulent or illegal use of any identification card by any person unless the pharmacy has been notified that the card has been canceled or discontinued and that the program administrator has been […]

Section 34-23-115 – Reimbursement Rates.

Section 34-23-115 Reimbursement rates. No agreement between a program administrator and a pharmacy shall establish reimbursement rates or procedures that result in reimbursement rates for services rendered to persons covered by the plan which are less than the usual and customary rates paid by consumers not covered by a third party plan for the same […]

Section 34-23-116 – Article Not Applicable to Certain Services.

Section 34-23-116 Article not applicable to certain services. This article shall not apply to any services rendered pursuant to provisions of the Alabama Medicaid Program, to the Public Education Employees’ Health Insurance Plan, or to any corporation organized under the provisions of Title 10, Chapter 4, Article 6, for establishment and operation of health care […]

Section 34-23-117 – No Programs to Be Instituted Until Notice Given.

Section 34-23-117 No programs to be instituted until notice given. After June 27, 1981, no third party prescription programs shall be instituted in this state unless: (1) The program administrator has given written notice of the provisions of the particular program to all pharmacies in this state as defined in Section 34-23-1. (2) All pharmacies […]

Section 34-23-118 – Compliance With Article Required of All Programs.

Section 34-23-118 Compliance with article required of all programs. After June 27, 1981, no third party prescription program shall be instituted, nor shall existing agreement or contract be renewed unless they are in compliance with the provisions of this article. (Acts 1981, No. 81-337, p. 477, §11.)