§ 56-7-3107 — Information to be provided regarding maximum allowable cost lists - Updating maximum allowable cost lists

Tennessee § 56-7-3107

• Jurisdiction: Tennessee
• Title: 56

Text

(a) A pharmacy benefits manager or covered entity shall make available to each pharmacy with which the pharmacy benefits manager or covered entity has a contract and to each pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, at the beginning of the term of a contract and upon renewal of a contract: (1) The sources used to determine the maximum allowable costs for the drugs and medical products and devices on each maximum allowable cost list; (2) Every maximum allowable cost for individual drugs used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy; and (3) Upon request, every maximum allowable cost list used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy. (b) A pharmacy benefits manager or covered entity shall: (1) Update each maximum allowable cost list at least every three (3) business days, as required by § 56-7-3104(b) ; (2) Make the updated lists available to every pharmacy with which the pharmacy benefits manager or covered entity has a contract and to every pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, in a readily accessible, secure and usable web-based format or other comparable format or process; and (3) Utilize the updated maximum allowable costs to calculate the payments made to the contracted pharmacies within five (5) business days.

Legislative History

Added by 2014 Tenn. Acts, ch. 857,s 2, eff. 1/1/2015.