Sec. 20. (a) The commissioner shall do the following:
(1) Prescribe an application for use in applying for a license to operate as a pharmacy benefit manager.
(2) Adopt rules under IC 4-22-2 to establish the following:
(A) Pharmacy benefit manager licensing requirements.
(B) Licensing fees.
(C) A license application.
(D) Financial standards for pharmacy benefit managers.
(E) Reporting requirements described in section 21 of this chapter.
(F) The time frame for the resolution of an appeal under section 22 of this chapter.
(b) The commissioner may do the following:
(1) Charge a license application fee and renewal fees established under subsection (a)(2) in an amount not to exceed five hundred dollars ($500) to be deposited in the department of insurance fund established by IC 27-1-3-28.
(2) Examine or audit the books and records of a pharmacy benefit manager one (1) time per year to determine if the pharmacy benefit manager is in compliance with this chapter.
(3) Adopt rules under IC 4-22-2 to:
(A) implement this chapter; and
(B) specify requirements for the following:
(i) Prohibited market conduct practices.
(ii) Data reporting in connection with violations of state law.
(iii) Maximum allowable cost list compliance and enforcement requirements, including the requirements of sections 22 and 23 of this chapter.
(iv) Prohibitions and limits on pharmacy benefit manager practices that require licensure under IC 25-22.5.
(v) Pharmacy benefit manager affiliate information sharing.
(vi) Lists of health plans administered by a pharmacy benefit manager in Indiana.
(c) Financial information and proprietary information submitted by a pharmacy benefit manager to the department is confidential.
As added by P.L.68-2020, SEC.1.
Structure Indiana Code
Article 1. Department of Insurance
Chapter 24.5. Pharmacy Benefit Managers
27-1-24.5-1. "Covered Individual"
27-1-24.5-2. "Effective Rate of Reimbursement"
27-1-24.5-3. "Equal Access and Incentives"
27-1-24.5-6. "Independent Pharmacies"
27-1-24.5-7. "Maximum Allowable Cost"
27-1-24.5-8. "Maximum Allowable Cost List"
27-1-24.5-10. "Pharmacist Services"
27-1-24.5-12. "Pharmacy Benefit Manager"
27-1-24.5-13. "Pharmacy Benefit Manager Affiliate"
27-1-24.5-14. "Pharmacy Benefit Manager Network"
27-1-24.5-15. "Pharmacy Services Administrative Organization"
27-1-24.5-19. Equal Access and Incentives; Prohibited Acts
27-1-24.5-19.5. Federal Drug Pricing Program
27-1-24.5-20. Acts of the Commissioner; Confidentiality
27-1-24.5-21. Annual Reporting Requirements; Trade Secrets
27-1-24.5-22. Required Information; Appeals Process; Auditing Procedures
27-1-24.5-22.5. Aggregated Information From Pharmacy Benefit Manager Reports
27-1-24.5-22.6. Filing Complaints With Department of Insurance
27-1-24.5-24. Information Necessary for Appeal
27-1-24.5-25. Party's Right to Audit; Amounts Paid; Consideration
27-1-24.5-26. Disclosure of Contract With Another Party
27-1-24.5-27. Contracts of Pharmacy Services Administrative Organizations
27-1-24.5-27.5. Pharmacist May Not Be Required to Collect Higher Copayment for Prescription Drug