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Utah Code Title 31A. Insurance Code § 31A-46-301. Reporting requirements

Current as of May 05, 2022 | Updated by FindLaw Staff

(1) Before April 1 of each year, a pharmacy benefit manager operating in the state shall report to the department, for the previous calendar year:

(a) any insurer, pharmacy, or pharmacist in the state with which the pharmacy benefit manager had a contract;

(b) the total value, in the aggregate, of all rebates and administrative fees that are attributable to enrollees of a contracting insurer;  and

(c) if applicable, the percentage of aggregate rebates that the pharmacy benefit manager retained under the pharmacy benefit manager's agreement to provide pharmacy benefits management services to a contracting insurer.

(2) Records submitted to the commissioner under Subsections (1)(b) and (c) are a protected record under Title 63G, Chapter 2, Government Records Access and Management Act.

(3)(a) The department shall publish the information provided by a pharmacy benefit manager under Subsection (1)(c) in the annual report described in Section 31A-2-201.2.

(b) The department may not publish information submitted under Subsection (1)(b) or (c) in a manner that:

(i) makes a specific submission from a contracting insurer or pharmacy benefit manager identifiable;  or

(ii) is likely to disclose information that is a trade secret as defined in Section 13-24-2.

(c) At least 30 days before the day on which the department publishes the data, the department shall provide a pharmacy benefit manager that submitted data under Subsection (1)(b) or (c) with:

(i) a general description of the data that will be published by the department;

(ii) an opportunity to submit to the department, within a reasonable period of time and in a manner established by the department by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:

(A) any correction of errors, with supporting evidence and comments;  and

(B) information that demonstrates that the publication of the data will violate Subsection (3)(b), with supporting evidence and comments.

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Cite this article: FindLaw.com - Utah Code Title 31A. Insurance Code § 31A-46-301. Reporting requirements - last updated May 05, 2022 | https://codes.findlaw.com/ut/title-31a-insurance-code/ut-code-sect-31a-46-301/

Read this complete Utah Code Title 31A. Insurance Code § 31A-46-301. Reporting requirements on Westlaw

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