Pennsylvania Code
Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

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The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 54 Pa.B. 5598 (August 31, 2024).

34 Pa. Code § 127.133. Payments for prescription drugs and pharmaceuticals—effect of denial of coverage by insurers.

§ 127.133. Payments for prescription drugs and pharmaceuticals—effect of denial of coverage by insurers.

 If an injured employe pays more than 110% of the average wholesale price of a prescription drug because the insurer initially does not accept liability for the claim under the act, or denies liability to pay for the prescription, the insurer shall reimburse the injured employe for the actual cost of the prescription drugs, once liability has been admitted or determined.


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