| (a) A member must obtain a covered outpatient drug
from a network pharmacy provider contracted with the member's health
care MCO, except at provided in §353.913 of this subchapter (relating
to Managed Care Organization Requirements Concerning Out-of-network
Outpatient Pharmacy Services).
(b) A member may receive up to a 90-day supply of a
covered outpatient drug.
(c) A health care MCO cannot require a member to obtain
a specialty drug or other covered outpatient drug from a mail-order
pharmacy unless a mail-order pharmacy is the only available dispensing
source for the drug. A health care MCO cannot charge the member for
mail-order services, including the cost of the drug, fees, or other
related services.
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