Section 26-52-104 – Maximum Allowable Cost; Offering Information and Alternatives.
26-52-104. Maximum allowable cost; offering information and alternatives. (a) To place a drug on a maximum allowable cost list, a pharmacy benefit manager shall ensure that the drug is: (i) Rated “A” or “B” in the most recent version of the United States Food and Drug Administration’s Approved Drug Products with Therapeutic Equivalence Evaluations (Orange […]
Section 26-52-101 – Licensure of Pharmacy Benefit Managers.
26-52-101. Licensure of pharmacy benefit managers. No person shall act or hold himself out as a pharmacy benefit manager in this state unless he obtains a license from the department. The department shall through rules establish license requirements and procedures for the licensing of pharmacy benefit managers consistent with this article. The requirements shall only […]
Section 26-52-102 – Definitions.
26-52-102. Definitions. (a) As used in this article: (i) “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; (ii) “Insurer” means the entity defined in W.S. 26-1-102(a)(xvi) and who provides health insurance […]
Section 26-52-103 – Pharmacy Benefit Manager Audits.
26-52-103. Pharmacy benefit manager audits. (a) Any pharmacy benefit manager or person acting on behalf of a pharmacy benefit manager who conducts an audit of a pharmacy shall follow the following procedures: (i) Provide written notice to the pharmacy not less than ten (10) business days before conducting any on-site, initial audit; (ii) Conduct any […]