(a) Falsified an application for registration or for the renewal of a registration or engaged in any dishonest act in relation to the application;
(b) Engaged in dishonesty, fraud or gross negligence in the conduct of business as a pharmacy benefit manager;
(c) Engaged in conduct that resulted in a conviction of a felony under the laws of any state or of the United States, to the extent that such conduct may be considered under ORS 670.280;
(d) Was convicted under the laws of any state or of the United States of any crime of which an essential element is dishonesty or fraud;
(e) Had a certificate of authority or authority to conduct business as a pharmacy benefit manager denied, revoked or suspended in another state;
(f) Failed to pay a civil penalty imposed by final order of the department or to comply with the terms of suspension set by the department;
(g) Failed to meet the terms of a consent decree approved by a court of competent jurisdiction in this state, or a consent order made between the department and the pharmacy benefit manager;
(h) Refused to be examined or to produce accounts, records or files for examination, including the refusal by any officer of the applicant or registrant to give information with respect to the affairs of the pharmacy benefit manager, or refused to perform any other legal obligation with respect to an examination by the department; or
(i) Violated any rule or order of the department or any provision of the Insurance Code.
(2) The department may prescribe by rule a procedure by which a pharmacy or an entity acting on behalf of a pharmacy may file a complaint with the department alleging that a pharmacy benefit manager has engaged in conduct described in this section. The department may restrict the right of a pharmacy or entity to file a complaint only to the extent necessary to prevent abuse of the complaint process. [2017 c.73 §2]
Note: See note under 735.530.
Structure 2021 Oregon Revised Statutes
Volume : 18 - Financial Institutions, Insurance
Chapter 735 - Alternative Insurance
Section 735.005 - Definitions for ORS 735.005 to 735.145.
Section 735.065 - Required association functions; assessments.
Section 735.075 - Discretionary association functions.
Section 735.095 - Contents of plan of operation.
Section 735.150 - Definitions for ORS 735.150 to 735.190.
Section 735.152 - Application of laws.
Section 735.156 - Confidentiality of documents and materials; public disclosure.
Section 735.160 - Business name.
Section 735.166 - Investment requirements for association captive insurer.
Section 735.170 - Rating organization.
Section 735.174 - Examination; frequency; scope; payment of expenses.
Section 735.176 - Compliance with sound actuarial principles.
Section 735.178 - Suspension or revocation of certificate of authority.
Section 735.180 - Branch captive insurer as pure captive insurer; rules.
Section 735.184 - Requirements for foreign captive insurer to provide insurance in this state.
Section 735.186 - Management of assets of captive reinsurer.
Section 735.188 - Application of captive reinsurer for certificate of authority.
Section 735.190 - Incorporation of captive reinsurer.
Section 735.200 - Legislative findings; purpose.
Section 735.205 - Definitions for ORS 735.200 to 735.260.
Section 735.210 - Formation of market assistance plans; rules.
Section 735.215 - Findings prior to formation of joint underwriting association; hearing.
Section 735.245 - Conditions for policyholder surcharge.
Section 735.265 - Liquor liability insurance risk and rate classifications; rules.
Section 735.305 - Definitions for ORS 735.300 to 735.365.
Section 735.320 - Relationship to insurance guaranty fund and joint underwriting association.
Section 735.330 - Purchasing groups; notice of intent to do business; registration; exceptions.
Section 735.400 - Purposes of ORS 735.400 to 735.495.
Section 735.405 - Definitions for ORS 735.400 to 735.495.
Section 735.410 - Conditions for procuring insurance through nonadmitted insurer; rules.
Section 735.415 - Qualifications for placement of coverage with nonadmitted insurer.
Section 735.420 - Declaration of ineligibility of surplus lines insurer.
Section 735.425 - Filing by licensee after placement of surplus lines insurance.
Section 735.430 - Surplus Line Association of Oregon; fees.
Section 735.455 - Authority of licensee; rules.
Section 735.460 - Records of licensee; examination.
Section 735.465 - Monthly reports; rules.
Section 735.470 - Premium tax; collection; payment; refund; rules.
Section 735.480 - Suspension or revocation of license; refusal to renew; grounds.
Section 735.485 - Actions against surplus lines insurer.
Section 735.495 - Short title; severability.
Section 735.500 - Requirements for certification as retainer medical practice; disclosures; rules.
Section 735.510 - Notice to department of specified changes to practice.
Section 735.515 - Charges for services not covered by contract.
Section 735.530 - Definitions for ORS 735.530 to 735.552.
Section 735.532 - Registration of pharmacy benefit managers; fees; rules.
Section 735.534 - Claim reimbursement; maximum allowable costs; documentation; rules.
Section 735.540 - Definitions for ORS 735.540 to 735.552.
Section 735.542 - Pharmacy claims audits; requirements.
Section 735.544 - Pharmacy claims audits; standards for review of claims.
Section 735.546 - Pharmacy claims audits; auditors.
Section 735.548 - Pharmacy claims audits; validation of claims.
Section 735.552 - Pharmacy claims audits; exception for fraud.