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Wyoming Statutes Title 26. Insurance Code § 26-52-105. Transparency; prohibitions

Current as of January 01, 2024 | Updated by Findlaw Staff

(a) A pharmacy benefit manager or an agent of a pharmacy benefit manager shall not:

(i) Cause or knowingly permit the use of an advertisement, promotion, solicitation, representation, proposal or offer that is untrue, deceptive or misleading;

(ii) Charge a pharmacist or pharmacy provider a fee for any of the following:

(A) The submission of a claim;

(B) Enrollment or participation in a retail pharmacy network;

(C) The development or management of claims processing services or claims payment services related to participation in a retail pharmacy network;

(D) An application to apply for network access with the pharmacy benefit manager;

(E) Credentialing or re-credentialing;

(F) [Vetoed by Governor March 17, 2023.]

(iii) Retroactively deny or reduce reimbursement for a covered pharmacy service or claim after adjudication of the claim, unless:

(A) The original claim was fraudulent; or

(B) The denial or reduction is necessary to correct errors found in an audit, provided that the audit was conducted in compliance with W.S. 26-52-103.

(iv) [Vetoed by Governor March 17, 2023.]

(v) [Vetoed by Governor March 17, 2023.]

(vi) [Vetoed by Governor March 17, 2023.]

(vii) Prohibit a pharmacy, pharmacy services administrative organization, contracting agent or agent of a pharmacy from sharing, upon request, copies of pharmacy benefit manager contracts with the department of insurance;

(viii) Prohibit, restrict or limit disclosure of information to the insurance commissioner, law enforcement or other state or federal government officials who are investigating or examining a complaint or conducting a review of the pharmacy benefit manager's compliance with the requirements of this chapter;

(ix) [Vetoed by Governor March 17, 2023.]

(b) [Vetoed by Governor March 17, 2023.]

(c) Insurers, pharmacies and pharmacy benefit managers shall adhere to all state laws and rules when mailing or shipping prescription drugs into the state.

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Cite this article: FindLaw.com - Wyoming Statutes Title 26. Insurance Code § 26-52-105. Transparency; prohibitions - last updated January 01, 2024 | https://codes.findlaw.com/wy/title-26-insurance-code/wy-st-sect-26-52-105/

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