Usually, the pharmacy has no choice but to take the loss, as the pharmacy benefits manager (PBM) or the patient’s insurer dictates reimbursements as part of the privilege of the pharmacy being in its network. Other times, the pharmacy does not even know what it will be reimbursed until after the claim is processed. Starting in July, a new law in Mississippi will allow a pharmacy to refuse to provide drugs or services if it is not paid more than acquisition cost. Sponsored by Sam Mims (R-McComb), Mississippi Gov. Phil Bryant recently signed the bill into law.
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