SECTION 353.915. Access to Network Pharmacies

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(a) A health care managed care organization (MCO) must ensure that a member has access to at least one network pharmacy within 15 miles from his or her residence.
(b) A health care MCO must ensure that a member has access to at least one network pharmacy with 24-hour coverage within 75 miles of his or her residence.
(c) If a network pharmacy provider is not available to a member within the mileage radius specified in subsection (a) or (b) of this section, the health care MCO must submit to the Health and Human Services Commission for approval data that indicates covered outpatient pharmacy services are not available to the member within the required distance.

Source Note: The provisions of this §353.915 adopted to be effective March 1, 2012, 37 TexReg 1292

                    
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