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Earlier editions: 2020-112018-11

DIVISION 2. CLASSES OF INSURANCE 1880-12880.8›PART 2. LIFE AND DISABILITY INSURANCE 10110-11549›CHAPTER 1. The Contract 10110-10198.10›ARTICLE 1. General Provisions 10110-10127.20

§ 10125.1

California Insurance Code · 2026 edition · updated 2026-10-04 · California

(a) Every insurer issuing disability insurance that covers hospital, medical, or surgical expenses that offers coverage for a service that is within the scope of practice of a duly licensed pharmacist shall pay or reimburse the cost of the service performed by a pharmacist at an in-network pharmacy or a pharmacist at an out-of-network pharmacy if the insurer has an out-of-network pharmacy benefit.

(b) Payment or reimbursement may be made pursuant to this section for a service performed by a duly licensed pharmacist only when all of the following conditions are met:

(1) The service performed is within the lawful scope of practice of the pharmacist.

(2) The coverage otherwise provides reimbursement for identical services performed by other licensed health care providers.

(c) Nothing in this section shall require the insurer to pay a claim to more than one provider for duplicate service or be interpreted to limit physician reimbursement.

(Amended by Stats. 2023, Ch. 322, Sec. 2. (AB 317) Effective January 1, 2024.)

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