Michigan Compiled Laws
Act 11 of 2022 - Pharmacy Benefit Manager Licensure and Regulation Act (550.811.new - 550.845.new)
Section 550.840.new - Enforcement of Act; Examination and Audit.

***** 550.840.new THIS NEW SECTION IS EFFECTIVE JANUARY 1, 2024 *****
Sec. 30.
(1) The director shall enforce this act.
(2) The director may examine or audit the relevant books and records of a pharmacy benefit manager providing claims processing services or other drug or device services for a health plan to determine if the pharmacy benefit manager is in compliance with this act.
(3) All of the following apply to information or data acquired during an examination under subsection (2), or otherwise acquired under this act:
(a) The information or data is considered proprietary and confidential.
(b) The information or data is not subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(c) The information or data is only to be used for purposes of ensuring a pharmacy benefit manager's compliance with this act.
History: 2022, Act 11, Eff. Jan. 1, 2024

Structure Michigan Compiled Laws

Michigan Compiled Laws

Chapter 550 - General Insurance Laws

Act 11 of 2022 - Pharmacy Benefit Manager Licensure and Regulation Act (550.811.new - 550.845.new)

Section 550.811.new - Short Title.

Section 550.815.new - Definitions; a to I.

Section 550.817.new - Definitions; M to P.

Section 550.819.new - Definitions; R to W.

Section 550.821.new - Pharmacy Benefit Manager; Licensure; Application Requirements; Modification Notice; Grounds for Refusal, Revocation, Denial, or Suspension; Fines; Notice and Hearings; Investigation of Officers, Directors and Owners; Renewal.

Section 550.823.new - Promulgation of Rules.

Section 550.825.new - Contractual Responsibilities; Conflict of Interest; Exception for Certain Audits.

Section 550.827.new - Pharmacy Benefit Manager Network; Report; Waiver; Prohibition on Spread Pricing and Fees for Electronic Processing.

Section 550.829.new - Prohibited Conduct.

Section 550.831.new - Contractual Restrictions and Limitations With Pharmacists or Pharmacies; Disclosure of Costs; Payment at Point of Sale.

Section 550.833.new - Transparency Report; Requirements; Exempt From Freedom of Information Act; Report to Legislature; Inapplicable to Medicaid Contracts.

Section 550.837.new - Maximum Allowable Costs; Pharmacy Benefit Manager Duties.

Section 550.838.new - Authorization to Conduct Audit; Process and Duties; Written Report; Extrapolation Audit Prohibition; Inapplicable to Certain Investigations; Carrier Pharmacy Audits Not Impaired or Superseded.

Section 550.839.new - Retail Pharmacies; Contractual Restrictions and Limitations; Use of Untrue, Deceptive, or Misleading Advertisements; Reversal and Resubmission of Claims; Termination of Pharmacy From Pharmacy Benefit Manager Network; Retaliation...

Section 550.840.new - Enforcement of Act; Examination and Audit.

Section 550.841.new - Contract Compliance; License Requirement.

Section 550.843.new - Retention Schedule; Records, Books, Papers, and Other Data; Destruction or Disposal of Certain Documents Prohibited.

Section 550.845.new - Scope of Act.