Pennsylvania Statutes Title 62 P.S. Poor Persons and Public Welfare § 449.2. Pharmacy benefits manager audit and obligations

(a) The Department of the Auditor General may conduct an audit and review of a pharmacy benefits manager that provides pharmacy benefits management to a medical assistance managed care organization under contract with the department. The Department of the Auditor General may review all previous audits completed by the department and shall have access to all documents it deems necessary to complete the review and audit.

(b) Any information disclosed or produced by a pharmacy benefits manager or a medical assistance managed care organization for the use of the department or the Department of the Auditor General under this section shall not be subject to the act of February 14, 2008 (P.L. 6, No. 3),  1 known as the “Right-to-Know Law.”

(c) As used in this section, the following words and phrases shall have the meanings given to them in this subsection:

“Medical assistance managed care organization” means a Medicaid managed care organization as defined in section 1903(m)(1)(a) of the Social Security Act (49 Stat. 620, 42 U.S.C. § 1396b(m)(1)(A)) that is a party to a Medicaid managed care contract with the department.

“Pharmacy benefits management” shall have the same meaning as in section 449.  2

“Pharmacy benefits manager” means a person, business or other entity that performs pharmacy benefits management. The term shall include any affiliated ownership of a medical assistance managed care organization that performs pharmacy benefits management.