Current through the 2023 Legislative Session.
Section 10125.1 - Reimbursement or payment for services performed by pharmacist for insurer under group insurance(a) Every insurer issuing disability insurance that covers hospital, medical, or surgical expenses that offers coverage for a service that is within the scope of practice of a duly licensed pharmacist shall pay or reimburse the cost of the service performed by a pharmacist at an in-network pharmacy or a pharmacist at an out-of-network pharmacy if the insurer has an out-of-network pharmacy benefit.(b) Payment or reimbursement may be made pursuant to this section for a service performed by a duly licensed pharmacist only when all of the following conditions are met:(1) The service performed is within the lawful scope of practice of the pharmacist.(2) The coverage otherwise provides reimbursement for identical services performed by other licensed health care providers.(c) Nothing in this section shall require the insurer to pay a claim to more than one provider for duplicate service or be interpreted to limit physician reimbursement.Amended by Stats 2023 ch 322 (AB 317),s 2, eff. 1/1/2024.Added by Stats. 1996, Ch. 527, Sec. 2. Effective January 1, 1997.