§ 23-92-508 — Enforcement

(a) The Insurance Commissioner shall enforce this subchapter. (b) (1) The commissioner may examine or audit the books and records of a pharmacy benefits manager providing claims processing services or other prescription drug or device services for a health benefit plan to determine if the pharmacy benefits manager is in compliance with this subchapter. (2) The information or data acquired during an examination under subdivision (b)(1) of this section is: (A) Considered proprietary and confidential under § 23-61-107(a)(4) and § 23-61-207 ; and (B) Not subject to the Freedom of Information Act of 1967, § 25-19-101 et seq. (c) After notice and opportunity for hearing, the commissioner may: (1) Impose a penalty of up to five thousand dollars ($5,000) per violation against a pharmacy benefits manager if the commissioner finds that the pharmacy benefits manager has not: (A) Followed the process established for determining pricing or costs under the Maximum Allowable Cost List under § 17-92-507 ; or (B) Used the national average drug acquisition cost under § 23-92-506(b) ; or (2) Revoke or suspend the license of a pharmacy benefits manager if the commissioner finds that the pharmacy benefits manager: (A) Has committed a pattern of violations of this subchapter; (B) Has not followed the process established for determining pricing and costs under the Maximum Allowable Cost List under § 17-92-507 ; or (C) Has not used the national average drug acquisition cost under § 23-92-506(b) .

Legislative History

Amended by Act 2023, No. 302,§ 5, eff. 8/1/2023. Added by Act 2018EX2, No. 1,§ 1, eff. 3/15/2018. Added by Act 2018EX2, No. 3,§ 1, eff. 3/19/2018.