Or. Admin. Code § 836-200-0418 - [Effective 6/29/2025] Aggregated Rebate and Payment Reports
(1) For the
purposes of this rule, "health benefit plan" has the meaning defined in ORS
743B.005(16).
(2) For the purposes of this rule, "pharmacy
benefit manager" has the meaning defined in ORS
735.530.
(3) No later than June 1 of each year, a
pharmacy benefit manager required to be registered with the Department of
Consumer and Business Services must file a report using the form and manner
prescribed by the department. The report must contain the following information
for the immediately preceding calendar year:
(a) The aggregated amount of rebates, fees,
price protection payments, and any other payments the pharmacy benefit manager
received from manufacturers related to managing the pharmacy benefits for
carriers issuing health benefit plans in this state.
(b) The aggregated amount of any payments, as
described in subsection (3)(a) of this rule, that were passed on to carriers
issuing health benefit plans in this state.
(c) The aggregated amount of any payments, as
described in subsection (3)(a) of this rule, that were passed on to enrollees
in a health benefit plan at the point of sale in this state.
(d) The aggregated amount of any payments, as
described in subsection (3)(a) of this rule, that were retained as revenue by
the pharmacy benefit manager.
(4) The amount described in section (3)(a) of
this rule should be equal to the sum of the amounts described in sections
(3)(b), (3)(c), and (3)(d) of this rule.
(5) The amounts described in section (3) of
this rule must include all payments that the pharmacy benefit manager received
from manufacturers directly and any payments the pharmacy benefit manager
received from manufacturers by the pharmacy benefit manager's subsidiaries, any
other entities that the pharmacy benefit manager holds an ownership in, or any
entities which hold an ownership interest in the pharmacy benefit
manager.
Notes
Statutory/Other Authority: ORS 731.244
Statutes/Other Implemented: ORS 743.025 & 735.537
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.