loading…
loading…
loading…
(a) Beginning March 1, 2027, and annually thereafter, each pharmacy benefit manager shall
submit a transparency report containing data from the prior calendar year to the health insurance
commissioner. The transparency report shall contain the following information:
(1) The aggregate amount of all rebates that the pharmacy benefit manager received from
all pharmaceutical manufacturers for all health carrier clients and for each health carrier client;
(2) The aggregate administrative fees that the pharmacy benefit manager received from all
manufacturers for all health carrier clients and for each health carrier client;
(3) The aggregate retained rebates that the pharmacy benefit manager received from all
pharmaceutical manufacturers and did not pass through to health carriers;
(4) The aggregate retained rebate percentage as defined in § 27-84-2;
(5) The highest, lowest, and mean aggregate retained rebate percentage for all health carrier
clients and for each health carrier client; and
(6) A response to a set of standard questions developed by the health insurance
commissioner regarding business practices including, but not limited to, rebate pass through
practices, spread pricing, pharmacy network development, and utilization management.
(b) A pharmacy benefit manager providing information under this section shall provide
complete information to the health insurance commissioner but may request that the health
insurance commissioner designate certain material as a trade secret with a factual and legal analysis
supporting such request. Disclosure, however, may be ordered by a court of this state for good
cause shown or made in a court filing.
(c) Within sixty (60) days of receipt of complete reports, the health insurance commissioner
shall publish the transparency report of each pharmacy benefit manager on the agency’s website in
a form and manner that does not violate state trade secrets law.
(d) The health insurance commissioner may impose administrative penalties in accordance
with § 42-14-16 for violations of this section.