HB515 Alabama 2018 Session

Summary

Primary Sponsor

Craig Ford

Independent

Session

Regular Session 2018

Title

Worker's compensation, prescription benefits, employer liability further provided, Secs. 25-5-77, 25-5-293, 25-5-314 am'd.

Summary

HB 515 would cap employer liability for workers' compensation prescription costs at contracted rates when a contract exists with a physician, pharmacy, or PBM, and would require non-party providers to dispense at that contracted rate and treat it as full reimbursement.

What This Bill Does

The bill changes how prescription costs are reimbursed in workers' compensation. If an employer has a contract with a provider for prescription benefits at a rate lower than the usual maximum or prevailing rate, that contracted rate becomes the amount the employer owes for medications. Providers not party to the contract may dispense medications only at the contracted rate and must treat that payment as reimbursement in full. The contracted rates are treated as reasonably necessary and used to determine reimbursement for medications.

Who It Affects

• Employers who have contracts with a physician, pharmacy, or PBM for prescription benefits; their liability for prescription costs would be limited to the contracted rate.
• Prescription providers (physicians, pharmacies, PBMs) and injured employees; providers not under contract may dispense only at the contracted rate, and employees' authorized medical expenses would be paid at those contracted rates.

Key Provisions

• If the employer contracts with a physician, pharmacy, or PBM for prescription benefits at a rate lower than the maximum fee schedule or prevailing rate, the contracted rate is deemed reimbursement in full.
• A provider not party to the contract may dispense medications only if they do so at the contracted rate and treat payment of that rate as reimbursement in full.
• The employer's liability for medications is limited to the contracted rate when such a contract exists, overriding higher prevailing rates or schedules for those medications.
• The act becomes effective on the first day of the third month after passage and approval.

AI-generated summary using openai/gpt-5-nano on Feb 24, 2026. May contain errors — refer to the official bill text for accuracy.

Subjects

Workers' Compensation