Sec. 21.27.940. Pharmacy audits; restrictions.
The requirements of AS 21.27.901 – 21.27.955 do not apply to an audit (1) in which suspected fraudulent activity or other intentional or wilful misrepresentation is evidenced by a physical review, a review of claims data, a statement, or another investigative method; or (2) of claims paid for under the medical assistance program under AS […]
Sec. 21.27.945. Drug pricing list; procedural requirements.
(a) A pharmacy benefits manager shall (1) make available to each network pharmacy at the beginning of the term of the network pharmacy’s contract, and upon renewal of the contract, the methodology and sources used to determine the drug pricing list; (2) provide a telephone number at which a network pharmacy may contact an employee […]
Sec. 21.27.950. Multi-source generic drug appeal.
(a) A pharmacy benefits manager shall establish a process by which a network pharmacy, or a network pharmacy’s contracting agent, may appeal the reimbursement for a multi-source generic drug. A pharmacy benefits manager shall resolve an appeal from a network pharmacy within 10 calendar days after the network pharmacy or the contracting agent submits the […]
Sec. 21.27.955. Definitions.
In AS 21.27.901 – 21.27.955, (1) “audit” means an official examination and verification of accounts and records; (2) “claim” means a request from a pharmacy or pharmacist to be reimbursed for the cost of filling or refilling a prescription for a drug or for providing a medical supply or device; (3) “extrapolation” means the practice […]
Sec. 21.27.990. Definitions.
In this chapter, (1) “accredited state” means a state in which the insurance department or regulatory agency of that state has qualified as meeting the minimum financial regulatory standards adopted and established by the National Association of Insurance Commissioners; (2) “affiliate” or “affiliated” has the meaning given in AS 21.22.200; (3) “appointment” means an act […]
Sec. 21.27.790. Surplus lines broker qualifications.
In addition to the general qualifications under AS 21.27.020, to qualify for issuance or for renewal of a resident surplus lines broker license, an applicant or licensee shall (1) be licensed as either an insurance producer or managing general agent for property and casualty lines of authority; (2) if required by the director by regulation, […]
Sec. 21.27.810. Surplus lines broker records.
In addition to any other records requirements under this chapter, a surplus lines broker shall maintain in organized form a complete record including (1) the amount of insurance and perils insured; (2) a complete description of property insured and the location of the property; (3) gross premium charged; (4) a return premium paid; (5) the […]
Sec. 21.27.820. Denial, nonrenewal, suspension, or revocation of surplus lines broker license.
In addition to other action available under this title, the director may deny issuance of or not renew a license, or may suspend or revoke a license of a surplus lines broker issued under this chapter for any of the following causes: (1) removal of the resident surplus lines broker’s office from this state; (2) […]
Sec. 21.27.830. Independent adjuster qualifications.
In addition to the general qualifications under AS 21.27.020, to qualify for issuance or renewal of an independent adjuster license, an applicant or licensee shall (1) have at least six months active working experience within the previous two calendar years as either an independent adjuster trainee, an insurance producer, a managing general agent, a reinsurance […]
Sec. 21.27.840. Trainee independent adjusters.
(a) An individual resident who does not have the experience with reference to the handling of loss claims but who otherwise meets the requirements of AS 21.27.830, may be employed by a licensed independent adjuster as a trainee independent adjuster, subject to the provisions of this section. (b) Before the individual may handle loss claims, […]