Utah Code 49-20-503. Request for proposals for pharmacy benefits manager for Public Employees’ Benefit and Insurance Program
Current as of: 2024 | Check for updates
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(1) When the board issues a request for proposals for a pharmacy benefits manager to provide pharmacy benefits management services for the program, the request for proposals shall:
Terms Used In Utah Code 49-20-503
- Board: means the Utah State Retirement Board established under Section 49-11-202. See Utah Code 49-11-102
- Pharmacy: is a s defined in Section 58-17b-102. See Utah Code 49-20-502
- Pharmacy benefits manager: means a person that provides a pharmacy benefits management service to the program. See Utah Code 49-20-502
- Program: means the Public Employees' Benefit and Insurance Program. See Utah Code 49-20-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) require each responder to comply with the pharmacy audit provisions of Section 58-17b-622 ; and
(1)(b) provide each responder with the option to include, among the billing options proposed, a billing option that complies with the requirements described in this section.
(2) The billing option described in Subsection (1) shall require the pharmacy benefits manager to, on at least a monthly basis, submit to the board an invoice for all pharmacy services paid by the pharmacy benefits manager on behalf of the program since the last request for payment or reimbursement.
(3) The invoice described in Subsection (2) shall state, as a separate item from any other amount:
(3)(a) the total amount due to the pharmacy benefits manager for all pharmacy services billed in the invoice; and
(3)(b) the total amount paid by the pharmacy benefits manager for the same pharmacy services for which payment is sought in that invoice.