§ 9474. Enforcement
§ 9474. Enforcement (a) Except as provided in subsection (d) of this section, in addition to any remedy available to the Commissioner under this title and any other remedy provided by law, a violation of this subchapter shall be considered a violation of the Vermont Consumer Protection Act in 9 V.S.A. chapter 63, subchapter 1. […]
§ 9473. Pharmacy benefit managers; required practices with respect to pharmacies
§ 9473. Pharmacy benefit managers; required practices with respect to pharmacies (a) Within 14 calendar days following receipt of a pharmacy claim, a pharmacy benefit manager or other entity paying pharmacy claims shall do one of the following: (1) Pay or reimburse the claim. (2) Notify the pharmacy in writing that the claim is contested […]
§ 9471. Definitions
§ 9471. Definitions As used in this subchapter: (1) “Beneficiary” means an individual enrolled in a health plan in which coverage of prescription drugs is administered by a pharmacy benefit manager and includes his or her dependent or other person provided health coverage through that health plan. [Subdivision (2) effective until January 1, 2023; for […]
§ 9472. Pharmacy benefit managers; required practices with respect to health insurers
§ 9472. Pharmacy benefit managers; required practices with respect to health insurers (a) A pharmacy benefit manager that provides pharmacy benefit management for a health plan shall discharge its duties with reasonable care and diligence and be fair and truthful under the circumstances then prevailing that a pharmacy benefit manager acting in like capacity and […]
§ 9472. Pharmacy benefit managers; required practices with respect to health insurers and covered persons
§ 9472. Pharmacy benefit managers; required practices with respect to health insurers and covered persons (a) A pharmacy benefit manager that provides pharmacy benefit management for a health plan has a fiduciary duty to its health insurer client that includes a duty to be fair and truthful toward the health insurer, to act in the […]