N.Y. Comp. Codes R. & Regs. tit. 11 § 456.5

Current through Register Vol. 46, No. 53, December 31, 2024

Section 456.5 - Contracts with parties related to pharmacy benefit management services

(a) Pursuant to Insurance Law section 2904, the department is authorized to request copies of the terms and conditions of any contract or arrangement between a pharmacy benefit manager and any other party relating to pharmacy benefit management services provided to health plans. Pharmacy benefit managers are prohibited from including in any such contracts any confidentiality provisions related to disclosures to the department and such contracts shall not require prior approval from any party prior to disclosure to the department. Upon the superintendent's request, the pharmacy benefit manager shall further transmit any such contracts to the department within 15 business days, unredacted and in full.

(b) Any pharmacy benefit manager that contracts with a subcontractor, affiliate, subsidiary, or other individual or entity to perform pharmacy benefit management services on behalf of the pharmacy benefit manager shall have in its contract with such subcontractor, affiliate, subsidiary, or other individual or entity that the department is authorized to request information directly from such subcontractor, affiliate, subsidiary, or other individual or entity related to the performance of pharmacy benefit management services for the pharmacy benefit manager, and such subcontractor, affiliate, subsidiary, or other individual or entity shall cooperate the department in connection with such request.

N.Y. Comp. Codes R. & Regs. Tit. 11 § 456.5

Adopted New York State Register November 27, 2024/Volume XLVI, Issue 48, eff. 11/27/2024