(a) Hospitals and pharmacies licensed in this state and state programs that provide health care coverage or health care services to patients, recipients, or other individuals in this state, including, but not limited to, Medicaid, PeachCare for Kids Program, alcohol and drug awareness programs, and the Department of Corrections shall provide such patients, recipients, or other individuals with referral information to the program for eligible drugs available through the program for: (1) Drugs not currently covered under a state program;(2) Patients who do not meet the eligibility coverage for a state program or become unenrolled or leave a state program;(3) Drugs that are covered under a state program but are otherwise inaccessible to a patient due to, but not limited to a gap in coverage or out-of-pocket costs that are too high for a specific patient, recipient, or other individual; a prior authorization requirement; step therapy requirements; or high co-payments; or(4) A patient, recipient, or other individual for a drug that is covered under a state program but that the claim for coverage is denied with respect to the specific patient, recipient, or other individual.(b) ent, recipient, or other individual for a drug that is covered under a state program but that the claim for coverage is denied with respect to the specific patient, recipient, or other individual.(b) Recipients of the federal Title X Family Planning Program shall make and document diligent efforts to subcontract with interested eligible recipients participating in the program to offer family planning services to rural and low-income populations.(c) If an eligible recipient offers value-added services and referrals, in addition to just providing medicine, such eligible recipient may also be eligible for discounted medication pricing to help widen such eligible recipient's formularies of medication and increase financial sustainability of its participation in the program.Added by 2024 Ga. Laws 473,§ 2-5, eff. 4/23/2024.
Georgia Legal Code