Iowa Code 510C.2 – Annual report to commissioner
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Terms Used In Iowa Code 510C.2
- following: when used by way of reference to a chapter or other part of a statute mean the next preceding or next following chapter or other part. See Iowa Code 4.1
- Internet: means the federated international system that is composed of allied electronic communication networks linked by telecommunication channels, that uses standardized protocols, and that facilitates electronic communication services, including but not limited to use of the world wide web; the transmission of electronic mail or messages; the transfer of files and data or other electronic information; and the transmission of voice, image, and video. See Iowa Code 4.1
- year: means twelve consecutive months. See Iowa Code 4.1
510C.2 Annual report to commissioner.
1. Each pharmacy benefits manager shall provide a report annually by February 15 to
the commissioner that contains all of the following information regarding prescription drug benefits provided to covered persons of each third-party payor with whom the pharmacy benefits manager has contracted during the prior calendar year:
a. The aggregate dollar amount of all rebates received by the pharmacy benefits manager.
b. The aggregate dollar amount of all administrative fees received by the pharmacy benefits manager.
c. The aggregate dollar amount of all third-party payor administrative service fees received by the pharmacy benefits manager.
d. The aggregate dollar amount of all rebates received by the pharmacy benefits manager that the pharmacy benefits manager did not pass through to the third-party payor.
e. The aggregate amount of all administrative fees received by the pharmacy benefits manager that the pharmacy benefits manager did not pass through to the third-party payor.
f. The aggregate retained rebate percentage as calculated by dividing the dollar amount in paragraph “”d”” by the dollar amount in paragraph “”a””.
g. Across all third-party payor clients with whom the pharmacy benefits manager was contracted, the highest and the lowest aggregate retained rebate percentages.
2. a. A pharmacy benefits manager shall provide the information pursuant to subsection
1 to the commissioner in a format approved by the commissioner that does not directly or indirectly disclose any of the following:
(1) The identity of a specific third-party payor.
(2) The price charged by a specific pharmaceutical manufacturer for a specific prescription drug or for a class of prescription drugs.
(3) The amount of rebates provided for a specific prescription drug or class of prescription drugs.
b. Information provided under this section by a pharmacy benefits manager to the commissioner that may reveal the identity of a specific third-party payor, the price charged by a specific pharmaceutical manufacturer for a specific prescription drug or class of prescription drugs, or the amount of rebates provided for a specific prescription drug or class of prescription drugs shall be considered a confidential record and be recognized and protected as a trade secret pursuant to § 22.7, subsection 3.
3. The commissioner shall publish, within sixty calendar days of receipt, the nonconfidential information received by the commissioner on a publicly accessible internet site. The information shall be made available to the public in a format that complies with subsection 2, paragraph “”a””.
2019 Acts, ch 88, §2; 2020 Acts, ch 1063, §282 – 284; 2022 Acts, ch 1113, §18 – 21, 23
1. Each pharmacy benefits manager shall provide a report annually by February 15 to
the commissioner that contains all of the following information regarding prescription drug benefits provided to covered persons of each third-party payor with whom the pharmacy benefits manager has contracted during the prior calendar year:
a. The aggregate dollar amount of all rebates received by the pharmacy benefits manager.
b. The aggregate dollar amount of all administrative fees received by the pharmacy benefits manager.
c. The aggregate dollar amount of all third-party payor administrative service fees received by the pharmacy benefits manager.
d. The aggregate dollar amount of all rebates received by the pharmacy benefits manager that the pharmacy benefits manager did not pass through to the third-party payor.
e. The aggregate amount of all administrative fees received by the pharmacy benefits manager that the pharmacy benefits manager did not pass through to the third-party payor.
f. The aggregate retained rebate percentage as calculated by dividing the dollar amount in paragraph “”d”” by the dollar amount in paragraph “”a””.
g. Across all third-party payor clients with whom the pharmacy benefits manager was contracted, the highest and the lowest aggregate retained rebate percentages.
2. a. A pharmacy benefits manager shall provide the information pursuant to subsection
1 to the commissioner in a format approved by the commissioner that does not directly or indirectly disclose any of the following:
(1) The identity of a specific third-party payor.
(2) The price charged by a specific pharmaceutical manufacturer for a specific prescription drug or for a class of prescription drugs.
(3) The amount of rebates provided for a specific prescription drug or class of prescription drugs.
b. Information provided under this section by a pharmacy benefits manager to the commissioner that may reveal the identity of a specific third-party payor, the price charged by a specific pharmaceutical manufacturer for a specific prescription drug or class of prescription drugs, or the amount of rebates provided for a specific prescription drug or class of prescription drugs shall be considered a confidential record and be recognized and protected as a trade secret pursuant to § 22.7, subsection 3.
3. The commissioner shall publish, within sixty calendar days of receipt, the nonconfidential information received by the commissioner on a publicly accessible internet site. The information shall be made available to the public in a format that complies with subsection 2, paragraph “”a””.
2019 Acts, ch 88, §2; 2020 Acts, ch 1063, §282 – 284; 2022 Acts, ch 1113, §18 – 21, 23