Maine Revised Statutes Title 24-A Sec. 4348 – Licensure of pharmacy benefits managers
Current as of: 2023 | Check for updates
|
Other versions
Beginning January 1, 2020, a person may not act as a pharmacy benefits manager in this State without first obtaining a license from the superintendent in accordance with this section and paying the licensing fee required under section 601, subsection 28?A. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
1. Applicant information. An applicant for licensure as a pharmacy benefits manager must file with the superintendent at least the following information:
A. The name of the applicant; [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
B. The address and telephone number of the applicant; [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
C. The name and address of the applicant’s agent for service of process in the State; [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
D. The name and address of each person beneficially interested in the applicant; and [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
E. The name and address of each person with management or control over the applicant. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
Terms Used In Maine Revised Statutes Title 24-A Sec. 4348
- Pharmacy: means an established location, either physical or electronic, that is licensed by the State and that has entered into a network pharmacy contract with a pharmacy benefits manager or carrier. See Maine Revised Statutes Title 24-A Sec. 4347
- Pharmacy benefits manager: means a person, business or other entity that, pursuant to a contract or under an employment relationship with a carrier, a self?insurance plan or other 3rd?party payer, either directly or through an intermediary, manages the prescription drug coverage provided by the carrier, self?insurance plan or other 3rd?party payer, including, but not limited to, processing and paying claims for prescription drugs, performing drug utilization review, processing drug prior authorization requests, adjudicating appeals or grievances related to prescription drug coverage, contracting with network pharmacies and controlling the cost of covered prescription drugs. See Maine Revised Statutes Title 24-A Sec. 4347
- Probation: A sentencing alternative to imprisonment in which the court releases convicted defendants under supervision as long as certain conditions are observed.
- Service of process: The service of writs or summonses to the appropriate party.
2. Qualification. The superintendent may issue a pharmacy benefits manager license to an applicant only if the superintendent is satisfied that the applicant possesses the necessary organization, expertise and financial integrity to supply the services sought to be offered.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
3. Restrictions permitted. The superintendent may issue a pharmacy benefits manager license subject to restrictions or limitations, including the type of services that may be supplied or the activities in which the pharmacy benefits manager may engage.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
4. Valid for 3 years. A license issued pursuant to this section is valid for a period of 3 years and must be renewed.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
5. Nontransferable. A license issued pursuant to this section is not transferable.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
6. Suspension, revocation or probationary license. The superintendent may suspend, revoke or place on probation a pharmacy benefits manager license under any of the following circumstances:
A. The pharmacy benefits manager has engaged in fraudulent activity that constitutes a violation of state or federal law; [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
B. The superintendent has received consumer complaints that justify an action under this subsection to protect the safety and interests of consumers; [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
C. The pharmacy benefits manager fails to pay the original issuance or renewal fee for the license; or [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
D. The pharmacy benefits manager fails to comply with a requirement set forth in this chapter. [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
7. Penalty for failure to obtain license. If a pharmacy benefits manager acts without obtaining a license pursuant to this section, the pharmacy benefits manager is subject to a fine of $5,000 per day for the period the pharmacy benefits manager is found to be in violation.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
8. Rules. The superintendent may adopt routine technical rules pursuant to Title 5, chapter 375, subchapter 2?A to administer and enforce the requirements of this section.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
9. Enforcement. The superintendent may enforce this section under sections 220 and 223 and other provisions of this Title.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
10. Registration remains effective until January 1, 2020 or registration date. The registration of a pharmacy benefits manager issued during 2019 in accordance with former section 1913 remains valid until January 1, 2020 or the next yearly anniversary of the registration date, whichever is later. Upon expiration of that registration, the pharmacy benefits manager shall obtain a license under this section in order to do business in this State.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
SECTION HISTORY
PL 2019, c. 469, §8 (NEW). PL 2019, c. 469, §9 (AFF).