§ 2907 — Revocation or suspension of a registration or license of a pharmacy benefit manager

§ 2907. Revocation or suspension of a registration or license of a\npharmacy benefit manager. (a) The superintendent may revoke, or may\nsuspend for a period the superintendent determines the registration or\nlicense of any pharmacy benefit manager if, after notice and hearing,\nthe superintendent determines that the registrant or licensee or any\nmember, principal, officer, director, or controlling person of the\nregistrant or licensee, has:\n (1) violated any insurance laws, section two hundred eighty-a of the\npublic health law or violated any regulation, subpoena or order of the\nsuperintendent or of another state's insurance commissioner, or has\nviolated any law in the course of his or her dealings in such capacity\nafter such registration or license has been issued or renewed pursuant\nto this article;\n (2) provided materially incorrect, materially misleading, materially\nincomplete or materially untrue information in the registration or\nlicense application;\n (3) obtained or attempted to obtain a registration or license through\nmisrepresentation or fraud;\n (4)(A) used fraudulent, coercive or dishonest practices;\n (B) demonstrated incompetence;\n (C) demonstrated untrustworthiness; or\n (D) demonstrated financial irresponsibility in the conduct of business\nin this state or elsewhere;\n (5) improperly withheld, misappropriated or converted any monies or\nproperties received in the course of business in this state or\nelsewhere;\n (6) intentionally misrepresented the terms of an actual or proposed\ninsurance contract;\n (7) admitted or been found to have committed any insurance unfair\ntrade practice or fraud;\n (8) had a pharmacy benefit manager registration or license, or its\nequivalent, denied, suspended or revoked in any other state, province,\ndistrict or territory;\n (9) failed to pay state income tax or comply with any administrative\nor court order directing payment of state income tax; or\n (10) ceased to meet the requirements for registration or licensure\nunder this article.\n (b) Before revoking or suspending the registration or license of any\npharmacy benefit manager pursuant to the provisions of this article, the\nsuperintendent shall give notice to the registrant or licensee and shall\nhold, or cause to be held, a hearing not less than ten days after the\ngiving of such notice.\n (c) If a registration or license pursuant to the provisions of this\narticle is revoked or suspended by the superintendent, then the\nsuperintendent shall forthwith give notice to the registrant or\nlicensee.\n (d) The revocation or suspension of any registration or license\npursuant to the provisions of this article shall terminate forthwith\nsuch registration or license and the authority conferred thereby. For\ngood cause shown, the superintendent may delay the effective date of a\nrevocation or suspension to permit the registrant or licensee to satisfy\nsome or all of its contractual obligations to perform pharmacy benefit\nmanagement services in the state.\n (e)(1) No individual, corporation, firm or association whose\nregistration or license as a pharmacy benefit manager has been revoked\npursuant to subsection (a) of this section, and no firm or association\nof which such individual is a member, and no corporation of which such\nindividual is an officer or director, and no controlling person of the\nregistrant or licensee shall be entitled to obtain any registration or\nlicense under the provisions of this article for a minimum period of one\nyear after such revocation, or, if such revocation be judicially\nreviewed, for a minimum period of one year after the final determination\nthereof affirming the action of the superintendent in revoking such\nlicense.\n (2) If any such registration or license held by a firm, association or\ncorporation be revoked, no member of such firm or association and no\nofficer or director of such corporation or any controlling person of the\nregistrant or licensee shall be entitled to obtain any registration or\nlicense under this article for the same period of time, unless the\nsuperintendent determines, after notice and hearing, that such member,\nofficer or director was not personally at fault in the matter on account\nof which such registration or license was revoked.\n (f) If any corporation, firm, association or person aggrieved shall\nfile with the superintendent a verified complaint setting forth facts\ntending to show sufficient ground for the revocation or suspension of\nany pharmacy benefit manager's registration or license, and the\nsuperintendent finds the complaint credible, then the superintendent\nshall, after notice and a hearing, determine whether such registration\nor license shall be suspended or revoked.\n (g) The superintendent shall retain the authority to enforce the\nprovisions of and impose any penalty or remedy authorized by this\nchapter against any person or entity who is under investigation for or\ncharged with a violation of this chapter, even if the person's or\nentity's registration or license has been surrendered, or has expired or\nhas lapsed by operation of law.\n (h) A registrant or licensee subject to this article shall report to\nthe superintendent any administrative action taken against the\nregistrant or licensee in another jurisdiction or by another\ngovernmental agency in this state within thirty days of the final\ndisposition of the matter. This report shall include a copy of the\norder, consent to order or other relevant legal documents.\n (i) Within thirty days of the initial pretrial hearing date, a\nregistrant or licensee subject to this article shall report to the\nsuperintendent any criminal prosecution of the registrant or licensee\ntaken in any jurisdiction. The report shall include a copy of the\ninitial complaint filed, the order resulting from the hearing and any\nother relevant legal documents.\n