Maine § 24-A §4350-D Treatment of pharmacy benefits manager compensation

Maine Statutes

§ 24-A §4350-D — Treatment of pharmacy benefits manager compensation

Maine·Title 24-A MAINE INSURANCE CODE·Ch. 56-C HEALTH PLANS THAT PROVIDE PRESCRIPTION DRUG BENEFITS

1.Definitions. As used in this section, unless the context otherwise indicates, the following terms have the following meanings.

2.Pharmacy benefits manager compensation included as administrative cost. If a carrier uses a pharmacy benefits manager to administer or manage prescription drug benefits provided for the benefit of covered persons, for purposes of calculating a carrier's anticipated loss ratio, any pharmacy benefits manager compensation:

3.Calculation of pharmacy benefits manager compensation. Each rate filing submitted by a carrier with respect to a health plan that provides coverage for prescription drugs or pharmacy services that is administered or managed by a pharmacy benefits manager must include:

4.Records. Upon request, a carrier shall provide any records to the supe

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1.
Definitions.
As used in this section, unless the context otherwise indicates, the following terms have the following meanings.
2.
Pharmacy benefits manager compensation included as administrative cost.
If a carrier uses a pharmacy benefits manager to administer or manage prescription drug benefits provided for the benefit of covered persons, for purposes of calculating a carrier's anticipated loss ratio, any pharmacy benefits manager compensation:
3.
Calculation of pharmacy benefits manager compensation.
Each rate filing submitted by a carrier with respect to a health plan that provides coverage for prescription drugs or pharmacy services that is administered or managed by a pharmacy benefits manager must include:
4.
Records.
Upon request, a carrier shall provide any records to the superintendent that relate to the calculation of the pharmacy benefits manager compensation.
5.
Documentation from pharmacy benefits manager.
A pharmacy benefits manager shall provide any necessary documentation requested by a carrier that relates to pharmacy benefits manager compensation in order to comply with the requirements of this section.

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