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Current as of January 02, 2024 | Updated by Findlaw Staff
(a) A pharmacy benefits manager or covered entity shall make available to each pharmacy with which the pharmacy benefits manager or covered entity has a contract and to each pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, at the beginning of the term of a contract and upon renewal of a contract:
(1) The sources used to determine the maximum allowable costs for the drugs and medical products and devices on each maximum allowable cost list;
(2) Every maximum allowable cost for individual drugs used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy; and
(3) Upon request, every maximum allowable cost list used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy.
(b) A pharmacy benefits manager or covered entity shall:
(1) Update each maximum allowable cost list at least every three (3) business days, as required by § 56-7-3104(b);
(2) Make the updated lists available to every pharmacy with which the pharmacy benefits manager or covered entity has a contract and to every pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, in a readily accessible, secure and usable web-based format or other comparable format or process; and
(3) Utilize the updated maximum allowable costs to calculate the payments made to the contracted pharmacies within five (5) business days.
Cite this article: FindLaw.com - Tennessee Code Title 56. Insurance § 56-7-3107 - last updated January 02, 2024 | https://codes.findlaw.com/tn/title-56-insurance/tn-code-sect-56-7-3107/
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature before relying on it for your legal needs.
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