§ 58-29E-4 — Request for disclosure of rebates and other revenues.

A third-party payor may request that a pharmacy benefit manager, with which it has a pharmacy benefit management services contract, disclose to the third-party payor the amount of all rebate revenues and the nature, type, and amounts of all other revenues that the pharmacy benefit manager receives from each pharmaceutical manufacturer with which the pharmacy benefit manager has a contract. Annually, at the time of contract renewal, the pharmacy benefit manager shall disclose in writing: (1) The aggregate amount, and for a list of drugs to be specified in the contract, the specific amount, of all rebates and other retrospective utilization discounts that are received by the pharmacy benefit manager, directly or indirectly, from each pharmaceutical manufacturer, and which are earned in connection with the dispensing of prescription drugs to covered individuals of the health benefit plans issued by the third-party payor or for which the third-party payor is the designated administrator; (2) The nature, type, and amount of all other revenue received by the pharmacy benefit manager, directly or indirectly, from each pharmaceutical manufacturer, for any other products or services, provided to the pharmaceutical manufacturer by the pharmacy benefit manager, with respect to programs that the third-party payor offers or provides to its covered individuals; and (3) Any prescription drug utilization information requested by the third-party payor and relating to covered individuals. A pharmacy benefit manager shall, within thirty days, provide the information requested in accordance with this section. If requested, the information must be provided no less than once each year. The contract entered into between the pharmacy benefit manager and the third-party payor must set forth any fees to be charged for drug utilization reports requested by the third-party payor.

Legislative History

SL 2004, ch 311, § 4; SL 2023, ch 166, § 4.