(a) Pharmacy benefits managers shall, and contracts for pharmacy benefits management must, comply with the requirements of this part.
lawyer at desk

Ask an insurance law question, get an answer ASAP!
Click here to chat with a lawyer about your rights.

Terms Used In Tennessee Code 56-7-3101

  • Commissioner: means the commissioner of commerce and insurance. See Tennessee Code 56-1-102
  • Complaint: A written statement by the plaintiff stating the wrongs allegedly committed by the defendant.
  • Pharmacy benefits manager: includes , but is not limited to, a health insurance issuer, managed health insurance issuer as defined in §. See Tennessee Code 56-7-3102
(b)

(1) The commissioner of commerce and insurance shall promulgate rules to effectuate the purposes of this part and part 32 of this chapter, including, but not limited to, rules to:

(A) Implement pharmacy benefits manager audits that are necessary to ensure compliance with this part and part 32 of this chapter; provided, such audits must not occur more than once every three (3) years unless the commissioner determines there is a need to investigate the financial condition of or legality of conduct by a pharmacy benefits manager;
(B) Provide for additional requirements for pharmacy benefits managers to obtain licensure pursuant to § 56-7-3113;
(C) Implement a complaint and administrative hearing process to effectuate § 56-7-3110; and
(D) Provide for such fees as the commissioner determines are reasonably necessary to administer this part and part 32 of this chapter, including, but not limited to, a fee to cover the cost of supervising compliance with this part and part 32 of this chapter, payable by a pharmacy benefits manager upon being the subject of an audit pursuant to this section.
(2) Rules must be promulgated in accordance with the Uniform Administrative Procedures Act, compiled in title 4, chapter 5. A violation of any rule issued pursuant to this section is a violation of this part.
  Previous section
Next section  
 Part 31 Contents