House Journal: Page 960: Wednesday, April 2, 2003
31 regarding the method by which the pharmacy is
32 compensated for services provided under the agreement
33 with the pharmacy benefits manager.
34 10. A pharmacy benefits manager shall not
35 terminate a pharmacy from a network or otherwise
36 penalize a pharmacy solely because of the pharmacy's
37 invoking of the pharmacy's right under the contract or
38 applicable law or regulation.
39 11. A pharmacy benefits manager's termination due
40 to incompetence or unprofessional behavior shall not
41 release the pharmacy benefits manager from the
42 obligation to make any payment due to the pharmacy for
43 services provided in special circumstances post-
44 termination to the enrollees at less than agreed-upon
45 rates.
46 12. Participation or lack of participation by a
47 pharmacy in a plan or network shall not affect
48 participation in any other plan or network offered by
49 a pharmacy benefits manager.
50 Sec. . NEW SECTION. 155B.13 DISCLOSURES.
Page 12
1 1. The following shall be provided to the pharmacy
2 benefits manager enrollees at the time of enrollment
3 or at the time the contract is issued and shall be
4 made available upon request or at least annually:
5 a. A list of the names and locations of all
6 affiliated pharmacists' services providers.
7 b. A description of the service area or areas
8 within which the pharmacy benefits manager provides
9 prescription services.
10 c. A description of the method of resolving
11 complaints of enrollees, including a description of
12 any arbitration procedure if complaints may be
13 resolved through a specified arbitration agreement.
14 d. Notice that the pharmacy benefits manager is
15 subject to regulation in this state by both the board
16 of pharmacy examiners and the commissioner of
17 insurance.
18 e. A prominent notice included within the evidence
19 of coverage, providing substantially the following:
20 "If you have any questions regarding an appeal or
21 grievance concerning the pharmacists' services that
22 you have been provided, which have not been
23 satisfactorily addressed by your plan, you may contact
24 the board of pharmacy examiners." The notice shall
25 also provide the toll-free telephone number, mailing
26 address, and electronic mail address of the board of
27 pharmacy examiners.
28 2. Any disclosure from a pharmacy benefits manager
29 to enrollees shall be written plainly, using terms
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League of Women Voters of Iowa
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