N.Y. Comp. Codes R. & Regs. Tit. 11 § 452.2 - Health plan right to an accounting
(a) Pharmacy
benefit managers that provide pharmacy benefit management services only for
health plans that provide workers' compensation or automobile insurance are
exempt from the requirements listed in Public Health Law section 280-a(2)(b)
and (c).
(b) Upon written request
of any health plan for which the pharmacy benefit manager provides pharmacy
benefit management services, a pharmacy benefit manager shall provide an
accounting of all funds received by the pharmacy benefit manager for pharmacy
benefit management services attributable to the health plan sufficient to
demonstrate that such funds were used or distributed only pursuant to the
pharmacy benefit manager's contract with the health plan or applicable
law.
(c) Each pharmacy benefit
manager shall have in place accounting measures, practices, and procedures that
will permit such an accounting to each health plan for which it performs
pharmacy benefit management services.
(d) A pharmacy benefit manager shall have a
commercially reasonable time of not more than 60 days to produce the accounting
to the health plan.
Notes
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.