§ 33-64-1. Definitions
As used in this chapter, the term: “Affiliate pharmacy” means a pharmacy which, either directly or indirectly through one or more intermediaries: Has an investment or ownership interest in a pharmacy benefits manager licensed under this chapter; Shares common ownership with a pharmacy benefits manager licensed under this chapter; or Has an investor or ownership […]
§ 33-64-2. License Requirements and Filing Fees
No person, business entity, or other entity shall act as or hold itself out to be a pharmacy benefits manager in this state, other than an applicant licensed in this state for the kinds of business for which it is acting as a pharmacy benefits manager, unless such person, business entity, or other entity holds […]
§ 33-64-3. Requirements and Procedures Affecting Pharmacy Benefits Managers; Surety Bond
Every applicant for a pharmacy benefits manager’s license shall file with the application and shall thereafter maintain in force a bond in the amount of $100,000.00 in favor of the Commissioner executed by a corporate surety insurer authorized to transact insurance in this state. The terms and type of the bond shall be established by […]
§ 33-64-4. Pharmacy Benefits Manager Shall Not Engage in the Practice of Medicine; Recommended Use of Licensed Physician
No pharmacy benefits manager shall engage in the practice of medicine, except as otherwise provided in subsection (b) of this Code section. Any physician employed by or contracted with a pharmacy benefits manager advising on or making determinations specific to a Georgia insured in connection with a prior authorization or step therapy appeal or determination […]
§ 33-64-5. Audit Requirements Applicable to Pharmacy Benefits Managers
Pharmacy benefits managers, whether licensed pursuant to this chapter or exempt from licensure pursuant to subsection (l) of Code Section 33-64-2, shall be subject to Code Section 26-4-118, “The Pharmacy Audit Bill of Rights,” to the same extent and in the same manner as pharmacies. History. Code 1981, § 33-64-5 , enacted by Ga. L. […]
§ 33-64-6. Pharmacy Benefits Manager Shall Not Have to Be Licensed as an Administrator
A pharmacy benefits manager licensed pursuant to this chapter shall not be required to obtain a license as an administrator pursuant to Article 2 of Chapter 23 of this title to perform any function as a pharmacy benefits manager pursuant to this chapter. History. Code 1981, § 33-64-6 , enacted by Ga. L. 2010, p. […]
§ 33-62-3. Submission of Supporting Documentation; Confidentiality; Disclosure
The statement of actuarial opinion shall be provided with the annual statement in accordance with rules and regulations promulgated by the Commissioner regarding property and casualty annual statement instructions and shall be treated as a public document. Documents, materials, or other information in the possession or control of the department that are considered an actuarial […]
§ 33-64-7. Commissioner’s Authority Over Rules and Regulations
The Commissioner shall enforce the provisions of this chapter and may promulgate rules and regulations to implement the provisions of this chapter to ensure the safe and proper operations of pharmacy benefits managers in this state. In addition to all other authority granted by this title, the Commissioner may: Conduct financial examinations and compliance audits […]
§ 33-63-1. Legislative Findings
The General Assembly finds that guaranteed asset protection waivers are not insurance. All guaranteed asset protection waivers issued on or after the date of enactment of this chapter shall not be construed as insurance. History. Code 1981, § 33-63-1 , enacted by Ga. L. 2008, p. 1097, § 1/SB 470; Ga. L. 2019, p. 533, […]
§ 33-64-8. Electronic Prior Authorization Drug Requests With Health Care Providers
As used in this Code section, “electronic prior authorization” or “e-prior authorization” means a requirement that a prescriber obtain approval via electronic media from a health plan to prescribe a specific medication prior to dispensing. Facsimiles shall not be considered an electronic submission under this Code section except in the event that such electronic media […]