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This entry was published on 2022-03-04
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Reporting requirements for pharmacy benefit managers
Insurance (ISC) CHAPTER 28, ARTICLE 29
§ 2904. Reporting requirements for pharmacy benefit managers. (a)(1)
On or before July first of each year, every pharmacy benefit manager
shall report to the superintendent, in a statement subscribed and
affirmed as true under penalties of perjury, the information requested
by the superintendent including, without limitation,

(i) any pricing discounts, rebates of any kind, inflationary payments,
credits, clawbacks, fees, grants, chargebacks, reimbursements, other
financial or other reimbursements, incentives, inducements, refunds or
other benefits received by the pharmacy benefit manager; and

(ii) the terms and conditions of any contract or arrangement,
including other financial or other reimbursements incentives,
inducements or refunds between the pharmacy benefit manager and any
other party relating to pharmacy benefit management services provided to
a health plan including but not limited to, dispensing fees paid to

(2) The superintendent may require the filing of quarterly or other
statements, which shall be in such form and shall contain such matters
as the superintendent shall prescribe.

(3) The superintendent may address to any pharmacy benefit manager or
its officers any inquiry in relation to its provision of pharmacy
benefit management services or any matter connected therewith. Every
pharmacy benefit manager or person so addressed shall reply in writing
to such inquiry promptly and truthfully, and such reply shall be, if
required by the superintendent, subscribed by such individual, or by
such officer or officers of the pharmacy benefit manager, as the
superintendent shall designate, and affirmed by them as true under the
penalties of perjury.

(b) In the event any pharmacy benefit manager or person does not
submit the report required by paragraph one of subsection (a) of this
section or does not provide a good faith response to an inquiry from the
superintendent pursuant to paragraph three of subsection (a) of this
section within a time period specified by the superintendent of not less
than fifteen business days, the superintendent is authorized to levy a
civil penalty, after notice and hearing, against such pharmacy benefit
manager or person not to exceed four thousand dollars per day for each
day beyond the date the report is due or the date specified by the
superintendent for response to the inquiry.

(c) All information, documents and material disclosed by a pharmacy
benefit manager under this section and in the possession or under
control of the superintendent shall be deemed confidential and not
subject to disclosure except where and as the superintendent determines
that disclosure is in the public interest. This subsection shall not
apply to information, documents and materials where they are in the
possession and under the control of a person or entity other than the