(1) A pharmacy benefit manager may not:
(a) Reimburse a network pharmacy an amount less than the contract price between the pharmacy benefit manager and the insurer, third-party payor, or the prescription drug purchasing consortium the pharmacy benefit manager has contracted with;
(b) Require a covered person to pay more at the point of sale for a covered prescription drug than is required under RCW
48.43.430; or
(c) Require or coerce a patient to use their owned or affiliated pharmacies.
(2) A pharmacy benefit manager shall:
(a) Apply the same utilization review, fees, days allowance, and other conditions upon a covered person when the covered person obtains a prescription drug from a pharmacy that is included in the pharmacy benefit manager's pharmacy network, including mail order pharmacies;
(b) Permit the covered person to receive delivery or mail order of a prescription drug through any network pharmacy that is not primarily engaged in dispensing prescription drugs to patients through the mail or common carrier; and
(c) For new prescriptions issued after January 1, 2026, receive affirmative authorization from a covered person before filling prescriptions through a mail order pharmacy.
(3) If a covered person is using a mail order pharmacy, the pharmacy benefit manager shall:
(a) Allow for dispensing at local network pharmacies under the following circumstances to ensure patient access to prescription drugs:
(i) If the prescription is delayed more than one day after the expected delivery date provided by the mail order pharmacy; or
(ii) If the prescription drug arrives in an unusable condition; and
(b) Ensure patients have easy and timely access to prescription counseling by a pharmacist.