DE| The Delaware Department of Insurance issued Bulletin No. 153 to all health insurance carriers and pharmacy benefit managers (PBMs) in response to widespread pharmacy closures, particularly following Rite Aid’s bankruptcy, and the resulting Emergency Order from the Board of Pharmacy. The Bulletin outlines regulatory expectations to ensure patients continue to have access to essential medications and that disruptions in pharmacy services are minimized. Key directives include:
- Emergency prescription coverage and streamlined transfers: Carriers and PBMs must honor one-time emergency refills, use alternative verification methods when prescriber authorization is unavailable, and ensure prescription and prior authorization transfers are handled swiftly, especially for patients displaced by pharmacy closures.
- Fair reimbursement and network adequacy: PBMs are required to provide fair reimbursement to pharmacies taking on new patients and maintain adequate pharmacy networks to prevent gaps in access, particularly in rural and underserved communities.
- Consumer protection and transparency: Carriers must avoid restrictive policies steering patients to specific pharmacies, proactively notify policyholders about closures, and offer dedicated support channels to assist with prescription transfers.