House Journal: Page 957: Wednesday, April 2, 2003
34 a written explanation of the reason for the
35 termination at least thirty days before the actual
36 termination unless the contract termination action is
37 taken as the result of any of the following:
38 (1) Loss of the pharmacy's or pharmacist's license
39 to practice pharmacy or loss of professional liability
40 insurance.
41 (2) Conviction of fraud or misrepresentation in
42 regard to the contract.
43 b. A pharmacy or pharmacist may request and
44 receive, within thirty days, a review of the proposed
45 termination by the board prior to the termination.
46 12. The pharmacy or pharmacist shall not be held
47 responsible for actions of the pharmacy benefits
48 manager or plan sponsors and the pharmacy benefits
49 manager or plan sponsors shall not be held responsible
50 for the actions of the pharmacy or pharmacist.
Page 9
1 Sec. . NEW SECTION. 155B.10 ENFORCEMENT.
2 1. The board shall develop formal investigation
3 and compliance procedures for responding to complaints
4 by health insurance plans or contract sponsors,
5 pharmacists, or enrollees concerning the failure of a
6 pharmacy benefits manager to comply with this chapter.
7 If, based upon an investigation or complaint, the
8 board has reason to believe that there is a violation
9 of this chapter, the board shall issue and serve upon
10 the pharmacy benefits manager concerned a statement of
11 the charges and a notice of a hearing to be held at a
12 time and place fixed in the notice, which shall not be
13 less than thirty days after notice is served. The
14 notice shall require the pharmacy benefits manager to
15 show cause why an order should not be issued directing
16 the company to cease and desist from the violation.
17 At the hearing, the pharmacy benefits manager shall
18 have an opportunity to be heard and to show cause why
19 an order should not be issued requiring the pharmacy
20 benefits manager to cease and desist from the
21 violation.
22 2. The board may perform an examination concerning
23 the quality of services of any pharmacy benefits
24 manager and providers with whom the pharmacy benefits
25 manager has contracts, agreements, or other
26 arrangements pursuant to its pharmacy benefits
27 management plan as often as the board deems necessary
28 for the protection of the interests of the people of
29 this state. The pharmacy benefits manager being
30 examined shall pay the cost of the examination.
31 Sec. . NEW SECTION. 155B.11 PRESCRIPTION DRUG
32 REIMBURSEMENT COSTS.
© 2003 Cornell College and
League of Women Voters of Iowa
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