DIR Fees Law – ALABAMA

ALABAMA SUMMARY OF EXISTING LAW

A health benefit plan that covers prescription drugs may not include a provision that requires an enrollee to make a payment for a prescription drug at the point of sale in an amount that exceeds the lesser of: the contracted co-payment amount or the amount an individual would pay for a prescription if that individual were paying without using a health benefit plan.

Link to Existing Law:

Ala.Code 1975 § 27-45A-5

PRACTICAL NOTE

While this law does not apply directly to DIR fees it could prevent post-point-of-sale clawbacks when the patient’s copayment amount is greater than the amount the pharmacy stands to retain.