Section 21.27.953 - [Effective 1/1/2025] Regulations relating to pharmacy benefits manager claims, grievances, activities, and appeals The director shall adopt regulations that provide standards and criteria for
(1) the structure and operation of pharmacy benefits manager reimbursement of pharmacy claims under this chapter;(2) procedures maintained by a pharmacy benefits manager to ensure that a pharmacy has the opportunity for appropriate resolution of grievances;(3) an independent review of pharmacy benefits manager activities under this title; and(4) requiring a pharmacy benefits manager to hear pricing appeals.Added by SLA 2024, ch. 61,sec. 10, eff. 1/1/2025, app. to an insurance policy or contract, including a contract between a pharmacy benefits manager and a pharmacy or pharmacist, issued, delivered, entered into, renewed, or amended on or after 1/1/2025.