House Journal: Page 951: Wednesday, April 2, 2003
40 that contracts with a pharmacy benefits manager for
41 delivery of prescription services.
42 15. "Usual and customary price" means the price
43 the pharmacist would have charged a cash-paying
44 patient for the same services on the same date
45 inclusive of any discounts applicable.
46 Sec. . NEW SECTION. 155B.4 CERTIFICATE OF
47 AUTHORITY.
48 1. A person shall not establish or operate as a
49 pharmacy benefits manager in this state to provide
50 pharmacy benefits management plans without first
Page 3
1 obtaining a certificate of authority from the board of
2 pharmacy examiners. A pharmacy benefits manager
3 providing pharmacy benefits management plans in this
4 state shall obtain a certificate of authority from the
5 board every four years.
6 2. A person may apply to the board to obtain a
7 certificate of authority to establish and operate as a
8 pharmacy benefits manager in compliance with this
9 chapter if the person obtains an annual license to do
10 business in this state from the commissioner under
11 section 155B.5.
12 3. The board may suspend or revoke a certificate
13 of authority issued to a pharmacy benefits manager
14 under this chapter or may deny an application for a
15 certificate of authority if the board finds any of the
16 following:
17 a. The pharmacy benefits manager is operating
18 significantly in contravention of its basic
19 organizational document.
20 b. The pharmacy benefits manager does not arrange
21 for pharmacists' services.
22 c. The pharmacy benefits manager has failed to
23 meet the requirements for issuance of a certificate of
24 authority established in this chapter.
25 d. The pharmacy benefits manager is unable to
26 fulfill its obligation to furnish pharmacists'
27 services as required under its pharmacy benefits
28 management plan.
29 e. The pharmacy benefits manager is no longer
30 financially responsible and may reasonably be expected
31 to be unable to meet its obligations to enrollees or
32 prospective enrollees.
33 f. The pharmacy benefits manager, or any person on
34 the company's behalf, has advertised or merchandised
35 its services in an untrue, misrepresentative,
36 misleading, deceptive, or unfair manner.
37 g. The continued operation of the pharmacy
38 benefits manager would be hazardous to its enrollees.
© 2003 Cornell College and
League of Women Voters of Iowa
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