Can a pharmacy or program administrator unilaterally change benefits for an insurance program?

A pharmacy or program administrator cannot unilaterally change benefits for an insurance program; rather, any changes must be offered to all participating pharmacies. This approach ensures fairness and transparency among all pharmacies involved in the insurance program. Unilateral changes would lead to inconsistencies and could create an environment of distrust, undermining the collaborative relationship between pharmacies and the insurance providers.

Changes made should involve a clear communication process, ensuring that all pharmacies are equally informed and have the opportunity to adjust their practices or offerings according to the new benefits. This maintains a level playing field and ensures compliance with legal and regulatory standards governing pharmacy practices and insurance operations.