H.B. 113

             1     

PHARMACY BENEFIT MANAGER AMENDMENTS

             2     
2014 GENERAL SESSION

             3     
STATE OF UTAH

             4     
Chief Sponsor: Bradley G. Last

             5     
Senate Sponsor: ____________

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill amends the Insurance Code to create a license for pharmacy benefit managers.
             10      Highlighted Provisions:
             11          This bill:
             12          .    establishes the Pharmacy Benefit Manager Act;
             13          .    defines terms;
             14          .    requires a license to operate as a pharmacy benefit manager;
             15          .    establishes:
             16              .    a license application process; and
             17              .    general requirements for a license;
             18          .    provides for license probation, termination, or surrender under certain conditions;
             19          .    establishes general duties regarding:
             20              .    maximum allowable cost reimbursement to a contracted pharmacy; and
             21              .    average reimbursement rates for multisource drugs;
             22          .    permits the Insurance Department to establish fees to pay the cost of administering
             23      the licensing chapter and designates the fee as a dedicated credit to the department;
             24          .    authorizes the commissioner of insurance to impose penalties for a violation of the
             25      chapter and designates the penalties as a dedicated credit to the department; and
             26          .    authorizes administrative rules.
             27      Money Appropriated in this Bill:


             28          None
             29      Other Special Clauses:
             30          This bill takes effect on July 1, 2014.
             31      Utah Code Sections Affected:
             32      ENACTS:
             33           31A-44-101 , Utah Code Annotated 1953
             34           31A-44-102 , Utah Code Annotated 1953
             35           31A-44-201 , Utah Code Annotated 1953
             36           31A-44-202 , Utah Code Annotated 1953
             37           31A-44-203 , Utah Code Annotated 1953
             38           31A-44-204 , Utah Code Annotated 1953
             39           31A-44-205 , Utah Code Annotated 1953
             40           31A-44-206 , Utah Code Annotated 1953
             41           31A-44-301 , Utah Code Annotated 1953
             42           31A-44-302 , Utah Code Annotated 1953
             43           31A-44-303 , Utah Code Annotated 1953
             44           31A-44-401 , Utah Code Annotated 1953
             45           31A-44-402 , Utah Code Annotated 1953
             46           31A-44-403 , Utah Code Annotated 1953
             47           31A-44-404 , Utah Code Annotated 1953
             48           31A-44-405 , Utah Code Annotated 1953
             49     
             50      Be it enacted by the Legislature of the state of Utah:
             51          Section 1. Section 31A-44-101 is enacted to read:
             52     
CHAPTER 44. PHARMACY BENEFIT MANAGER ACT

             53     
Part 1. General Provisions

             54          31A-44-101. Title.
             55          This chapter is known as the "Pharmacy Benefit Manager Act."
             56          Section 2. Section 31A-44-102 is enacted to read:
             57          31A-44-102. Definitions.
             58          For purposes of this chapter:


             59          (1) "Contracted pharmacy" or "pharmacy" means a pharmacy, as defined in Section
             60      58-17b-102 , participating in the network of a pharmacy benefit manager through a direct
             61      contract or through a contract with a pharmacy services administration organization or group
             62      purchasing organization.
             63          (2) "Dispense" or "dispensed" is as defined in Section 58-17b-102 .
             64          (3) "Drug" is as defined in Section 58-37-2 .
             65          (4) "Generic exclusivity period" means the period designated by the Food and Drug
             66      Administration following a successful challenge of an existing patent for an innovator drug
             67      during which a subsequent manufacturer of a pharmaceutically and therapeutically equivalent
             68      version of the innovator drug may market the pharmaceutically and therapeutically equivalent
             69      version without competition from other multiple source drug manufacturers.
             70          (5) "Maximum allowable cost" means:
             71          (a) a maximum reimbursement amount for a group of pharmaceutically and
             72      therapeutically equivalent multiple source drugs that are listed in the most recent edition of the
             73      Approved Drug Products with Therapeutic Equivalence Evaluations published by the Food and
             74      Drug Administration and for which there are no less than three nationally available equivalent
             75      drug products; or
             76          (b) any similar reimbursement amount that is used by a pharmacy benefit manager to
             77      reimburse pharmacies for multiple source drugs.
             78          (6) "Multiple source drug" means a drug for which there are three or more drug
             79      products that are:
             80          (a) rated by the Food and Drug Administration as therapeutically equivalent or
             81      bioequivalent;
             82          (b) determined by the Food and Drug Administration to be pharmaceutically equivalent
             83      or bioequivalent; and
             84          (c) sold or marketed in the United States during the same calendar quarter.
             85          (7) "Nationally available" means a product that is available for purchase in package
             86      sizes commonly purchased by retail pharmacies or chain-operated warehouses in sufficient
             87      supply from national pharmaceutical wholesalers and is not obsolete or temporarily
             88      unavailable.
             89          (8) "Obsolete" means a product that may be listed in national drug pricing compendia


             90      but is no longer actively marketed by the product manufacturer or labeler.
             91          (9) "Pharmacy benefit manager" means a person or entity that provides pharmacy
             92      benefit management services on behalf of a self-insured employer, insurance company, health
             93      maintenance organization, or other plan sponsor as defined by administrative rule adopted by
             94      the commissioner.
             95          (10) "Pharmacy benefit manager service" means any of the following services provided
             96      to a health benefit plan, or to a participant of the health benefit plan:
             97          (a) negotiating the amount to be paid by a health benefit plan for a prescription drug; or
             98          (b) administering or managing prescription drug benefits provided by the health benefit
             99      plan for the benefit of a participant of the health benefit plan, including:
             100          (i) mail service pharmacy;
             101          (ii) specialty pharmacy;
             102          (iii) claims processing;
             103          (iv) payment of a claim;
             104          (v) retail network management;
             105          (vi) clinical formulary development;
             106          (vii) clinical formulary management services;
             107          (viii) rebate contracting;
             108          (ix) rebate administration;
             109          (x) a participant compliance program;
             110          (xi) a therapeutic intervention program;
             111          (xii) a disease management program; or
             112          (xiii) a service that is similar to, or related to, a service described in Subsection (10)(a)
             113      or Subsections (10)(b)(i) through (xii).
             114          (11) "Prescription" is as defined in Section 58-37-2 .
             115          (12) "Prescription drug" means a drug that is provided by prescription.
             116          (13) "Temporarily unavailable" means a product that is experiencing short-term supply
             117      interruptions, and only an inconsistent or intermittent supply is available in the current market.
             118          Section 3. Section 31A-44-201 is enacted to read:
             119     
Part 2. Licensing

             120          31A-44-201. License required.


             121          (1) A person may not perform, offer to perform, or advertise any service as a pharmacy
             122      benefit manager in Utah without a valid license as a pharmacy benefit manager.
             123          (2) A person may not utilize the services of another person as a pharmacy benefit
             124      manager if the person knows or has reason to know that the other person does not have a
             125      license as required under Subsection (1).
             126          Section 4. Section 31A-44-202 is enacted to read:
             127          31A-44-202. Application for license.
             128          (1) To obtain a license as a pharmacy benefit manager, a person shall:
             129          (a) make an application for a license to the commissioner on forms and in a manner
             130      established by the commissioner, by rule, made in accordance with Title 63G, Chapter 3, Utah
             131      Administrative Rulemaking Act; and
             132          (b) pay a nonrefundable application fee.
             133          (2) The application described in Subsection (1)(a) shall:
             134          (a) state the applicant's:
             135          (i) name;
             136          (ii) address;
             137          (iii) Social Security number or federal employer identification number; and
             138          (iv) personal history, experience, education, and business record;
             139          (b) if the applicant is a natural person, state whether the applicant is 18 years of age or
             140      older;
             141          (c) state whether the applicant has committed an act that is a ground for denial,
             142      suspension, or revocation described in Section 31A-44-301 ; and
             143          (d) include any other information required by rule.
             144          (3) The commissioner may require the applicant to submit documentation that is
             145      reasonably necessary to verify the information contained in the application.
             146          (4) An applicant's Social Security number contained in an application filed under this
             147      section is a private record under Section 63G-2-302 .
             148          Section 5. Section 31A-44-203 is enacted to read:
             149          31A-44-203. General requirements for issuing a license.
             150          (1) The commissioner shall issue a license to act as a pharmacy benefit manager to a
             151      person who:


             152          (a) satisfies the character requirements described in Section 31A-44-204 ;
             153          (b) has not committed an act that is a ground for denial, suspension, or revocation
             154      under Section 31A-44-301 ;
             155          (c) if a nonresident, complies with Section 31A-44-205 ; and
             156          (d) pays the applicable fees under Sections 31A-3-103 and 31A-44-202 .
             157          (2) A person who is a licensed pharmacy benefit manager or who is an applicant for a
             158      pharmacy benefit manager license shall, in accordance with Subsection (3), provide a report to
             159      the commissioner of:
             160          (a) any administrative action taken against the person:
             161          (i) in another jurisdiction; or
             162          (ii) by another regulatory agency in this state; and
             163          (b) any criminal prosecution brought against the person in any jurisdiction.
             164          (3) A person who is required to file a report described in Subsection (2) shall:
             165          (a) file the report:
             166          (i) at the time the person applies for a pharmacy benefit manager license; and
             167          (ii) if an administrative action or prosecution described in Subsection (2) occurs after
             168      the person applies for a pharmacy benefit manager license:
             169          (A) for an administrative action, within 30 days after the day on which the final
             170      disposition of the administrative action occurs; or
             171          (B) for a criminal prosecution, within 30 days after the day on which the initial
             172      appearance before a court occurs; and
             173          (b) include a copy of the complaint and other legal documents relating to the initiation
             174      or disposition of the action or prosecution described in Subsection (2).
             175          (4) (a) The department may require a person who applies for a pharmacy benefit
             176      manager license to submit to a criminal background check as a condition of receiving a license.
             177          (b) A person, if required to submit to a criminal background check under Subsection
             178      (4)(a), shall:
             179          (i) submit a fingerprint card in a form acceptable to the department; and
             180          (ii) consent to a fingerprint background check by:
             181          (A) the Utah Bureau of Criminal Identification; and
             182          (B) the Federal Bureau of Investigation.


             183          (c) The department may request the following relating to a person who submits to a
             184      criminal background check under this Subsection (4):
             185          (i) criminal background information maintained pursuant to Title 53, Chapter 10, Part
             186      2, Bureau of Criminal Identification, from the Bureau of Criminal Identification; and
             187          (ii) complete Federal Bureau of Investigation criminal background checks through the
             188      national criminal history system.
             189          (d) Information obtained by the department from the review of criminal history records
             190      received under this Subsection (4) shall be used by the department for the purposes of:
             191          (i) determining if a person satisfies the character requirements described in Section
             192      31A-44-204 for issuance or renewal of a license;
             193          (ii) determining if a person has failed to maintain the character requirements described
             194      in Section 31A-44-204 ; and
             195          (iii) preventing a person who violates the federal Violent Crime Control and Law
             196      Enforcement Act of 1994, 18 U.S.C. Sec. 1033, from providing pharmacy benefit management
             197      services in the state.
             198          (e) If the commissioner requests the criminal background information described in this
             199      Subsection (4), the commissioner shall:
             200          (i) pay to the Department of Public Safety the costs incurred by the Department of
             201      Public Safety in providing the commissioner criminal background information described in
             202      Subsection (4)(c)(i);
             203          (ii) pay to the Federal Bureau of Investigation the costs incurred by the Federal Bureau
             204      of Investigation in providing the department criminal background information described in
             205      Subsection (4)(c)(ii); and
             206          (iii) charge the person applying for a license, or for consent to provide pharmacy
             207      benefit management services in the state, a fee equal to the aggregate of Subsections (4)(e)(i)
             208      and (ii).
             209          (5) The commissioner may deny a license application to act as a licensed pharmacy
             210      benefit manager to a person who:
             211          (a) fails to satisfy the requirements of this section; or
             212          (b) commits an act that is a ground for denial, suspension, or revocation described in
             213      Section 31A-44-301 .


             214          Section 6. Section 31A-44-204 is enacted to read:
             215          31A-44-204. Character requirements.
             216          An applicant for a license under this chapter shall demonstrate to the commissioner
             217      that:
             218          (1) the applicant has the good faith intent to engage in business as a pharmacy benefit
             219      manager; and
             220          (2) (a) if the applicant is a natural person, the applicant is:
             221          (i) competent and trustworthy; and
             222          (ii) at least 18 years old; or
             223          (b) if the applicant is an entity, the entity and all partners, directors, principal officers,
             224      or persons having comparable power over the entity are trustworthy.
             225          Section 7. Section 31A-44-205 is enacted to read:
             226          31A-44-205. Nonresident jurisdictional agreement.
             227          (1) The commissioner shall waive any license requirement for a license under this
             228      chapter and issue a nonresident pharmacy benefit manager license to a person who is a
             229      nonresident pharmacy benefit manager, if:
             230          (a) the person has a valid license from the person's home state;
             231          (b) the person applies for a nonresident pharmacy benefit manager license;
             232          (c) the person submits to the commissioner a copy of the application for a pharmacy
             233      benefit manager license that the nonresident license applicant submitted to the applicant's home
             234      state;
             235          (d) the person pays the applicable fees under Sections 31A-3-103 and 31A-44-202 ;
             236          (e) the nonresident license applicant's license in the applicant's home state is in good
             237      standing; and
             238          (f) the nonresident license applicant's home state awards nonresident pharmacy benefit
             239      manager licenses to residents of this state on the same basis as this state awards licenses to
             240      residents of that home state.
             241          (2) A nonresident applicant shall execute, in a form acceptable to the commissioner, an
             242      agreement to be subject to the jurisdiction of the Utah commissioner and courts on any matter
             243      related to the applicant's pharmacy benefit manager activities and insurance activities in Utah,
             244      on the basis of:


             245          (a) service of process under Sections 31A-2-309 and 31A-2-310 ; or
             246          (b) other service authorized in the Utah Rules of Civil Procedure.
             247          (3) The commissioner may verify the pharmacy benefit manager's licensing status
             248      through any applicable database.
             249          (4) The commissioner may not assess a greater fee for an insurance license or related
             250      service to a person not residing in this state based solely on the fact that the person does not
             251      reside in this state.
             252          Section 8. Section 31A-44-206 is enacted to read:
             253          31A-44-206. Form and contents of license.
             254          (1) A license issued under this chapter shall be in a form prescribed by the
             255      commissioner and shall include:
             256          (a) the name, address, and telephone number of the licensee;
             257          (b) the date of license issuance; and
             258          (c) any other information the commissioner considers advisable.
             259          (2) A pharmacy benefit manager doing business under any name other than the
             260      pharmacy benefit manager's legal name shall notify the commissioner before using the assumed
             261      name in this state.
             262          (3) (a) An organization shall be licensed as an agency if the organization acts as a
             263      pharmacy benefit manager.
             264          (b) An agency license issued under Subsection (3)(a) shall include the names of each
             265      natural person licensed under this chapter who is authorized to act as a pharmacy benefit
             266      manager for, or on behalf of, the organization in this state.
             267          Section 9. Section 31A-44-301 is enacted to read:
             268     
Part 3. License Probation and Termination

             269          31A-44-301. Revocation, suspension, surrender, lapsing, limiting, or otherwise
             270      terminating a license -- Rulemaking for renewal and reinstatement.
             271          (1) A license issued under this chapter remains in force until:
             272          (a) revoked or suspended under Subsection (4) or Section 31A-4-302 ;
             273          (b) surrendered to the commissioner and accepted by the commissioner in lieu of
             274      administrative action;
             275          (c) the licensee dies or is adjudicated incompetent as defined under:


             276          (i) Title 75, Chapter 5, Part 3, Guardians of Incapacitated Persons; or
             277          (ii) Title 75, Chapter 5, Part 4, Protection of Property of Persons Under Disability and
             278      Minors;
             279          (d) lapsed under Section 31A-44-303 ; or
             280          (e) voluntarily surrendered.
             281          (2) The following may be reinstated within one year after the day on which the license
             282      is no longer in force:
             283          (a) a lapsed license; or
             284          (b) a voluntarily surrendered license, except that a voluntarily surrendered license may
             285      not be reinstated after the license period in which the license is voluntarily surrendered.
             286          (3) Unless otherwise stated in the written agreement for the voluntary surrender of a
             287      license, submission and acceptance of a voluntary surrender of a license does not prevent the
             288      department from pursuing additional disciplinary or other action authorized under:
             289          (a) this title; or
             290          (b) rules made under this title in accordance with Title 63G, Chapter 3, Utah
             291      Administrative Rulemaking Act.
             292          (4) (a) If the commissioner makes a finding under Subsection (4)(b), as part of an
             293      adjudicative proceeding under Title 63G, Chapter 4, Administrative Procedures Act, the
             294      commissioner may, with respect to the license or license application to which the finding
             295      relates:
             296          (i) revoke the license;
             297          (ii) suspend the license for a specified period of 12 months or less;
             298          (iii) limit the license in whole or in part; or
             299          (iv) deny the license application.
             300          (b) The commissioner may take an action described in Subsection (4)(a) if the
             301      commissioner finds that the licensee or applicant:
             302          (i) is unqualified for a license under Section 31A-44-202 , 31A-44-203 , or 31A-44-204 ;
             303          (ii) has violated:
             304          (A) an insurance statute, including a statute in this chapter;
             305          (B) a rule that is valid under Subsection 31A-2-201 (3); or
             306          (C) an order that is valid under Subsection 31A-2-201 (4);


             307          (iii) is insolvent or the subject of receivership, conservatorship, rehabilitation, or other
             308      delinquency proceedings in any state;
             309          (iv) fails to pay a final judgment rendered against the person in this state within 60
             310      days after the day on which the judgment becomes final;
             311          (v) is an affiliate of, or under the same general management or interlocking directorate
             312      or ownership as, another pharmacy benefit manager that transacts business in this state without
             313      a license;
             314          (vi) refuses:
             315          (A) to be examined; or
             316          (B) to produce its accounts, records, and files for examination;
             317          (vii) has an officer who refuses to:
             318          (A) give information with respect to the pharmacy benefit manager's affairs; or
             319          (B) perform any other legal obligation as to an examination;
             320          (viii) provides information in a license application that is:
             321          (A) incorrect;
             322          (B) misleading;
             323          (C) incomplete; or
             324          (D) materially untrue;
             325          (ix) has violated an insurance law, valid rule, or valid order of the insurance
             326      department of another state, district, or territory of the United States;
             327          (x) has violated a law, rule, or order of another state, province, district, or territory of
             328      the United States that relates to regulation of a pharmacy benefit manager;
             329          (xi) has obtained or attempted to obtain a license through misrepresentation or fraud;
             330          (xii) has improperly withheld, misappropriated, or converted money or properties
             331      received in the course of doing business as a pharmacy benefit manager;
             332          (xiii) has intentionally misrepresented the terms of an actual or proposed contract;
             333          (xiv) has been convicted of a felony;
             334          (xv) has admitted, or been found to have committed, an insurance unfair trade practice
             335      or fraud;
             336          (xvi) in the conduct of business in this state or elsewhere has:
             337          (A) used fraudulent, coercive, or dishonest practices; or


             338          (B) demonstrated incompetence, untrustworthiness, or financial irresponsibility;
             339          (xvii) has had an insurance license, a pharmacy benefit manager license, or their
             340      equivalent, denied, suspended, or revoked in any other state, province, district, or territory of
             341      the United States;
             342          (xviii) has forged another's name to a document relating to the provision of a pharmacy
             343      benefit management service;
             344          (xix) has improperly used notes or any other reference material to complete an
             345      examination for a license;
             346          (xx) has knowingly accepted a pharmacy benefit management service from an
             347      individual who is not licensed;
             348          (xxi) has failed to comply with an administrative or court order imposing a child
             349      support obligation;
             350          (xxii) has failed to:
             351          (A) pay state income tax; or
             352          (B) comply with an administrative or court order directing payment of state income
             353      tax;
             354          (xxiii) has violated or permitted others to violate the federal Violent Crime Control and
             355      Law Enforcement Act of 1994, 18 U.S.C. Sec. 1033; or
             356          (xxiv) has engaged in methods and practices in the conduct of business that endanger
             357      the legitimate interests of customers and the public.
             358          (c) For purposes of this section, if a license is held by an agency, both the agency itself
             359      and any individual designated under the license are considered to be the holders of the agency
             360      license.
             361          (d) If an individual designated under the agency license commits an act or fails to
             362      perform a duty that is a ground for suspending, revoking, or limiting the individual's license,
             363      the commissioner may suspend, revoke, or limit the license of:
             364          (i) the individual;
             365          (ii) the agency, if the agency:
             366          (A) is reckless or negligent in the agency's supervision of the individual; or
             367          (B) knowingly participated in the act or failure to act that is the grounds for
             368      suspending, revoking, or limiting the license; or


             369          (iii) (A) the individual; and
             370          (B) the agency, if the agency meets the requirements of Subsection (4)(d)(ii).
             371          (5) A licensee under this chapter is subject to the penalties for acting as a licensee
             372      without a license if:
             373          (a) the licensee's license is:
             374          (i) revoked;
             375          (ii) suspended;
             376          (iii) limited;
             377          (iv) surrendered in lieu of administrative action;
             378          (v) lapsed; or
             379          (vi) voluntarily surrendered; and
             380          (b) the licensee:
             381          (i) continues to act as a licensee; or
             382          (ii) violates the terms of the license limitation.
             383          (6) A licensee under this chapter shall immediately report to the commissioner:
             384          (a) any revocation, suspension, or limitation of the person's license in any other state,
             385      province, district, or territory of the United States;
             386          (b) the imposition of a disciplinary sanction imposed on that person by any other state,
             387      province, district, or territory of the United States; or
             388          (c) a judgment or injunction entered against the person on the basis of conduct
             389      involving:
             390          (i) fraud;
             391          (ii) deceit;
             392          (iii) misrepresentation; or
             393          (iv) a violation of an insurance or pharmacy benefit manager law or rule.
             394          (7) (a) An order revoking a license under Subsection (4) or an agreement to surrender a
             395      license in lieu of administrative action may specify a time, not to exceed five years, within
             396      which the former licensee may not apply for a new license.
             397          (b) If no time is specified in the order or agreement described in Subsection (7)(a), the
             398      former licensee may not apply for a new license for five years from the day on which the order
             399      or agreement is made without the express written approval of the commissioner.


             400          (8) The commissioner shall promptly withhold, suspend, restrict, or reinstate the use of
             401      a license issued under this part if so ordered by the court.
             402          (9) The commissioner shall, by rule, prescribe the license renewal and reinstatement
             403      procedures in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act.
             404          Section 10. Section 31A-44-302 is enacted to read:
             405          31A-44-302. Probation -- Grounds for revocation.
             406          (1) The commissioner may place a licensee on probation for a period not to exceed 24
             407      months as follows:
             408          (a) after an adjudicative proceeding under Title 63G, Chapter 4, Administrative
             409      Procedures Act, for any circumstances that would justify a suspension under Section
             410      31A-44-301 ; or
             411          (b) at the issuance of a new license:
             412          (i) with an admitted violation under 18 U.S.C. Sec. 1033; or
             413          (ii) with a response to a background information question on a new license application
             414      indicating that:
             415          (A) the person has been convicted of a crime that is listed by rule made in accordance
             416      with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, as a crime that is grounds for
             417      probation;
             418          (B) the person is currently charged with a crime that is listed by rule made in
             419      accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act, as a crime that is
             420      grounds for probation, regardless of whether adjudication is withheld;
             421          (C) the person has been involved in an administrative proceeding regarding any
             422      professional or occupational license; or
             423          (D) any business in which the person is or was an owner, partner, officer, or director
             424      has been involved in an administrative proceeding regarding any professional or occupational
             425      license.
             426          (2) The commissioner may place a licensee on probation for a specified period no
             427      longer than 24 months if the licensee has admitted to a violation under 18 U.S.C. Sec. 1033.
             428          (3) A probation order under this section shall state the conditions for retention of the
             429      license, which shall be reasonable.
             430          (4) A violation of the probation is grounds for revocation pursuant to any proceeding


             431      authorized under Title 63G, Chapter 4, Administrative Procedures Act.
             432          Section 11. Section 31A-44-303 is enacted to read:
             433          31A-44-303. License lapse and voluntary surrender.
             434          (1) A license issued under this chapter shall lapse if the licensee fails to:
             435          (a) timely pay a fee under Sections 31A-3-103 and 31A-44-202 ;
             436          (b) submit a completed renewal application as required by Section 31A-44-202 ; and
             437          (c) maintain an active license in a resident state if the licensee is a nonresident licensee.
             438          (2) A licensee whose license lapses due to the following may request an action
             439      described in Subsection (3):
             440          (a) military service;
             441          (b) voluntary service for a period of time designated by the person for whom the
             442      licensee provides voluntary service; or
             443          (c) other extenuating circumstances, such as long-term medical disability.
             444          (3) A licensee described in Subsection (2) may request:
             445          (a) reinstatement of the license no later than one year after the day on which the license
             446      lapses; and
             447          (b) waiver of any of the following imposed for failure to comply with renewal
             448      procedures:
             449          (i) an examination requirement;
             450          (ii) reinstatement fees set under Section 31A-3-103 ; or
             451          (iii) other sanctions imposed for failure to comply with renewal procedures.
             452          (4) If a license issued under this chapter is voluntarily surrendered, the license may be
             453      reinstated:
             454          (a) during the license period in which the license is voluntarily surrendered; and
             455          (b) no later than one year after the day on which the license is voluntarily surrendered.
             456          Section 12. Section 31A-44-401 is enacted to read:
             457     
Part 4. General Duties - Enforcement

             458          31A-44-401. Maximum allowable cost reimbursement -- Appeal process.
             459          (1) Prior to the expiration of any generic exclusivity period, a pharmacy benefit
             460      manager shall not use maximum allowable cost as a basis for reimbursement to a pharmacy for
             461      a multiple source drug.


             462          (2) A pharmacy benefit manager may use maximum allowable cost as a basis for
             463      reimbursement to a pharmacy for a drug if:
             464          (a) there are at least three or more therapeutically equivalent multiple source drugs that
             465      have been coded as A rated by the Food and Drug Administration; and
             466          (b) the drugs identified in Subsection (2)(a) are available at a significant cost
             467      difference.
             468          (3) The maximum allowable cost shall be determined using comparable and current
             469      data on drug prices obtained from multiple nationally recognized, comprehensive data sources,
             470      including wholesalers, drug file vendors, and pharmaceutical manufacturers for drugs that are
             471      nationally available and readily available for purchase by all pharmacies in the state.
             472          (4) For every drug for which the pharmacy benefit manager uses maximum allowable
             473      cost to reimburse a contracted pharmacy, the pharmacy benefit manager shall:
             474          (a) include in the contract with the pharmacy:
             475          (i) information identifying the national drug pricing compendia and other data sources
             476      used to obtain the drug price data; and
             477          (ii) the methodology used to calculate the maximum allowable cost;
             478          (b) notify the contracted pharmacy at least 30 days prior to the initial implementation
             479      of a maximum allowable cost for a specific drug;
             480          (c) notify the contracted pharmacy at least 30 days prior to the discontinuation of a
             481      maximum allowable cost for a specific drug;
             482          (d) review and make necessary adjustments to the maximum allowable cost, using the
             483      most recent data sources identified in Subsection (4)(a)(i), at least once per week, and notify
             484      the contracted pharmacy of all adjustments within three business days of the adjustment;
             485          (e) provide a process for the contracted pharmacy to appeal the maximum allowable
             486      cost in accordance with Subsection (5); and
             487          (f) include in the contract with a contracted pharmacy a process to provide a weekly
             488      update to the pharmacy product pricing files used to reimburse the pharmacy.
             489          (5) (a) The right to appeal in Subsection (4)(e) shall be:
             490          (i) limited to 60 days following the initial claim adjudication; and
             491          (ii) investigated and resolved by the pharmacy benefit manager within seven business
             492      days.


             493          (b) If the appeal is denied, the pharmacy benefit manager shall provide the contracted
             494      pharmacy the reason for the denial and notify the contracted pharmacy where the drug product
             495      may be purchased at a price at or below the maximum allowable cost.
             496          (c) If the appeal is not denied:
             497          (i) the pharmacy benefit manager shall make a payment adjustment to a pharmacy
             498      retroactively to the date of the claim adjudication, if it is determined that the maximum
             499      allowable cost has been applied incorrectly; and
             500          (ii) when the change in maximum allowable cost for an adjusted cost rate becomes
             501      effective, all pharmacies in the pharmacy network shall be informed that the adjudicated claim
             502      may be submitted for payment again at the adjusted cost rate.
             503          Section 13. Section 31A-44-402 is enacted to read:
             504          31A-44-402. General duties of a pharmacy benefit manager.
             505          A pharmacy benefit manager shall:
             506          (1) have a written agreement with each health benefit plan to which the pharmacy
             507      benefit manager provides a pharmacy benefit management service; and
             508          (2) comply with the audit provisions of Section 58-17b-622 .
             509          Section 14. Section 31A-44-403 is enacted to read:
             510          31A-44-403. Fees -- Dedicated credit.
             511          The commissioner shall establish and impose a fee on a pharmacy benefit manager to
             512      pay the costs of administering this chapter. The fee imposed under this section shall be a
             513      dedicated credit, as defined in Section 51-5-3 , to the department to pay for the cost of
             514      administering this chapter.
             515          Section 15. Section 31A-44-404 is enacted to read:
             516          31A-44-404. Penalties imposed by commissioner -- Dedicated credit.
             517          (1) A pharmacy benefit manager that is found by the commissioner, after a hearing
             518      conducted in accordance with Title 63G, Chapter 4, Administrative Procedures Act, to be in
             519      violation of any provisions of this title, shall:
             520          (a) for each separate violation, pay a civil penalty in an amount designated by the
             521      commissioner by rule; and
             522          (b) be subject to revocation or suspension of the pharmacy benefit manager's license.
             523          (2) The penalties imposed under this section shall be a dedicated credit, as defined in


             524      Section 51-5-3 , to the department to pay for the cost of administering this chapter and the cost
             525      of market conduct reviews conducted by the department.
             526          (3) Nothing in this section affects the right of the commissioner to impose any other
             527      penalties provided in this title.
             528          Section 16. Section 31A-44-405 is enacted to read:
             529          31A-44-405. Administrative Rules.
             530          The commissioner may adopt administrative rules in accordance with Title 63G,
             531      Chapter 3, Utah Administrative Rulemaking Act, to enforce the provisions of this chapter.
             532          Section 17. Effective date.
             533          This bill takes effect on July 1, 2014.




Legislative Review Note
    as of 2-5-14 4:00 PM


Office of Legislative Research and General Counsel


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