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2025 Pennsylvania Consolidated & Unconsolidated Statutes
Title 40 - INSURANCE
Chapter 40 - Medication Synchronization
Section 4002 - Prorated daily cost-sharing rate
Universal Citation:
40 PA Cons Stat § 4002 (2025)
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§ 4002. Prorated daily cost-sharing rate.
A health insurance policy shall permit and apply a prorated daily cost-sharing rate to maintenance medications that are dispensed by a pharmacy as a partial supply if the pharmacist or prescriber determines the fill or refill to be in the best interest of the patient and the patient requests or agrees to a partial supply for the purpose of medication synchronization. The fill or refill under this section shall be limited to three times per year for each maintenance medication for a covered individual. For each clinically necessary synchronization thereafter, approval may be required at the discretion of the health insurance policy.
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