Indiana Code 27-1-24.5-20. Acts of the commissioner; confidentiality
(1) Prescribe an application for use in applying for a license to operate as a pharmacy benefit manager.
Terms Used In Indiana Code 27-1-24.5-20
- Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
- Commissioner: means the "insurance commissioner" of this state. See Indiana Code 27-1-2-3
- Department: means "the department of insurance" of this state. See Indiana Code 27-1-2-3
- Insurance: means a contract of insurance or an agreement by which one (1) party, for a consideration, promises to pay money or its equivalent or to do an act valuable to the insured upon the destruction, loss or injury of something in which the other party has a pecuniary interest, or in consideration of a price paid, adequate to the risk, becomes security to the other against loss by certain specified risks; to grant indemnity or security against loss for a consideration. See Indiana Code 27-1-2-3
- pharmacy: means the physical location:
Indiana Code 27-1-24.5-11
- pharmacy benefit manager: means an entity that, on behalf of a health plan, state agency, insurer, managed care organization, or other third party payor:
Indiana Code 27-1-24.5-12
- Year: means a calendar year, unless otherwise expressed. See Indiana Code 1-1-4-5
(A) Pharmacy benefit manager licensing requirements.
(B) Licensing fees.
(C) A license application.
(D) Financial standards for pharmacy benefit managers.
(E) Reporting requirements described in sections 21 and 29 of this chapter.
(F) The time frame for the resolution of an appeal under section 22 of this chapter.
(b) The commissioner may do the following:
(1) Charge a license application fee and renewal fees established under subsection (a)(2) in an amount not to exceed five hundred dollars ($500) to be deposited in the department of insurance fund established by IC 27-1-3-28.
(2) Examine or audit the books and records of a pharmacy benefit manager one (1) time per year to determine if the pharmacy benefit manager is in compliance with this chapter.
(3) Adopt rules under IC 4-22-2 to:
(A) implement this chapter; and
(B) specify requirements for the following:
(i) Prohibited market conduct practices.
(ii) Data reporting in connection with violations of state law.
(iii) Maximum allowable cost list compliance and enforcement requirements, including the requirements of sections 22 and 23 of this chapter.
(iv) Prohibitions and limits on pharmacy benefit manager practices that require licensure under IC 25-22.5.
(v) Pharmacy benefit manager affiliate information sharing.
(vi) Lists of health plans administered by a pharmacy benefit manager in Indiana.
(c) Financial information and proprietary information submitted by a pharmacy benefit manager to the department is confidential.
As added by P.L.68-2020, SEC.1. Amended by P.L.158-2024, SEC.8.