Utah Code 31A-46-307. Pharmacy benefit manager reporting
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(1) A pharmacy benefit manager may not enter into or renew a contract with an insurer on or after January 1, 2021, to administer or manage rebate contracting or rebate administration unless the pharmacy benefit manager agrees to regularly report to the insurer information regarding pharmaceutical manufacturer rebates received by the pharmacy benefit manager under the contract.
Terms Used In Utah Code 31A-46-307
- Contract: A legal written agreement that becomes binding when signed.
- Insurer: means the same as that term is defined in Section 31A-22-636. See Utah Code 31A-46-102
- Pharmaceutical manufacturer: means a pharmaceutical facility that manufactures prescription drugs. See Utah Code 31A-46-102
- Pharmacy: means the same as that term is defined in Section 58-17b-102. See Utah Code 31A-46-102
- Pharmacy benefit manager: means a person licensed under this chapter to provide a pharmacy benefits management service. See Utah Code 31A-46-102
- Rebate: means a refund, discount, or other price concession that is paid by a pharmaceutical manufacturer to a pharmacy benefit manager based on a prescription drug's utilization or effectiveness. See Utah Code 31A-46-102
(2) The quality and type of information required under Subsection (1) shall be detailed, claims level information unless the pharmacy benefit manager and insurer agree to waive this requirement in a separate written agreement.