(a) For purposes of this section, client means a health insurer, payor, or health benefit plan.
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Terms Used In Alabama Code 27-45A-9

  • Contract: A legal written agreement that becomes binding when signed.
  • following: means next after. See Alabama Code 1-1-1
(b) If requested by a client under subsection (d), a pharmacy benefits manager shall prepare an annual report by June 1 which discloses all of the following with respect to that client:

(1) The aggregate amount of all rebates that the pharmacy benefits manager received from pharmaceutical manufacturers on behalf of the client.
(2) The aggregate amount of the rebates the pharmacy benefits manager received from pharmaceutical manufacturers that did not pass through to the client.
(3) If a pharmacy benefits manager or any consultant providing pharmacy benefits management services engages in spread pricing, the aggregated amount of the difference between the amount paid by the client for prescription drugs and the actual amount paid to the pharmacy or pharmacist for pharmacist services. For purposes of this subdivision, “spread pricing” means the model of prescription drug reimbursement in which a pharmacy benefits manager charges a client a contracted price for prescription drugs, and the contract price for the prescription drugs differs from the amount the pharmacy benefits manager, directly or indirectly, pays the pharmacy or pharmacist for pharmacist services.
(c) Confidentiality of a report submitted under this section shall be governed by contract between the pharmacy benefits manager and the client.
(d) A pharmacy benefits manager shall annually notify all its clients in a timely manner that a report described in subsection (b) will be made available to the client by the pharmacy benefits manager if requested by the client.
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