Current through Vol. 41, No. 19, June 17, 2024
Section 365:25-29-14 - Inquiry/complaint handling process(a) Complaints alleging failure by the PBM to comply with the act, shall be made in writing to the Commissioner, supported by evidentiary materials. All complaints must include a completed "PBM Complaint Form" as promulgated by the Commissioner. (b) All audits of PBMs by health insurers shall include a review of complaints against the PBM to determine compliance with the terms of the contract between the PBM and the complainant.(c) PBMs must provide the complainant with a written notice as to the final disposition of the complaint.(d) As part of its response to the Department in connection with every complaint, the PBM must provide a statement to the Department that the complaint was carefully reviewed and could not be resolved under the terms and conditions of the contract.Okla. Admin. Code § 365:25-29-14
Adopted by Oklahoma Register, Volume 37, Issue 24, September 1, 2020, eff. 9/11/2020