Kentucky Statutes 304.9-053 – Licensure of pharmacy benefit managers
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(1) (a) In order to conduct business in this state, a pharmacy benefit manager shall first obtain a license from the commissioner. The license shall be in lieu of an administrator’s license as required by KRS § 304.9-052.
(b) A licensed pharmacy benefit manager performing utilization review, as defined in KRS § 304.17A-600, shall be registered as a private review agent in accordance with KRS § 304.17A-607.
(2) A pharmacy benefit manager seeking a license shall apply to the commissioner in writing on a form provided by the department. The application form shall state the name, address, official position, and professional qualifications of each individual responsible for the conduct of affairs of the pharmacy benefit manager, including all members of the board of directors, board of trustees, executive committee, other governing board or committee, the principal officers in the case of a corporation, the partners or members in the case of a partnership or association, and any other person who exercises control or influence over the affairs of the pharmacy benefit manager, and the name and address of the applicant’s agent for service of process in this state.
(3) Each application for a license and subsequent renewal for a license shall be accompanied by a nonrefundable fee of one thousand dollars ($1,000) and evidence of financial responsibility in an amount of one million dollars ($1,000,000).
(4) Any person acting as a pharmacy benefit manager on July 15, 2016, and who is required to obtain a license under subsection (1) of this section, shall obtain a license from the commissioner not later than January 1, 2017, in order to continue to do business in this state. If the license fee required in subsection (3) of this section is submitted after January 1, 2017, a penalty fee of five hundred dollars ($500) shall be paid.
(5) All licenses issued under this section shall be renewed annually in accordance with KRS § 304.9-260. If the renewal fee required in subsection (3) of this section is paid after the renewal date, a penalty fee of five hundred dollars ($500) shall be paid.
Effective: July 15, 2016
History: Created 2016 Ky. Acts ch. 79, sec. 2, effective July 15, 2016.
(b) A licensed pharmacy benefit manager performing utilization review, as defined in KRS § 304.17A-600, shall be registered as a private review agent in accordance with KRS § 304.17A-607.
Terms Used In Kentucky Statutes 304.9-053
- agent: includes managing general agent unless the context requires otherwise. See Kentucky Statutes 304.9-085
- Directors: when applied to corporations, includes managers or trustees. See Kentucky Statutes 446.010
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Pharmacy benefit manager: means an entity that, on behalf of a health benefit plan, state agency, insurer, managed care organization providing services under KRS Chapter 205, or other third-party payor:
(a) Contracts directly or indirectly with pharmacies to provide prescription drugs to individuals. See Kentucky Statutes 304.9-020 - Service of process: The service of writs or summonses to the appropriate party.
- State: when applied to a part of the United States, includes territories, outlying possessions, and the District of Columbia. See Kentucky Statutes 446.010
(2) A pharmacy benefit manager seeking a license shall apply to the commissioner in writing on a form provided by the department. The application form shall state the name, address, official position, and professional qualifications of each individual responsible for the conduct of affairs of the pharmacy benefit manager, including all members of the board of directors, board of trustees, executive committee, other governing board or committee, the principal officers in the case of a corporation, the partners or members in the case of a partnership or association, and any other person who exercises control or influence over the affairs of the pharmacy benefit manager, and the name and address of the applicant’s agent for service of process in this state.
(3) Each application for a license and subsequent renewal for a license shall be accompanied by a nonrefundable fee of one thousand dollars ($1,000) and evidence of financial responsibility in an amount of one million dollars ($1,000,000).
(4) Any person acting as a pharmacy benefit manager on July 15, 2016, and who is required to obtain a license under subsection (1) of this section, shall obtain a license from the commissioner not later than January 1, 2017, in order to continue to do business in this state. If the license fee required in subsection (3) of this section is submitted after January 1, 2017, a penalty fee of five hundred dollars ($500) shall be paid.
(5) All licenses issued under this section shall be renewed annually in accordance with KRS § 304.9-260. If the renewal fee required in subsection (3) of this section is paid after the renewal date, a penalty fee of five hundred dollars ($500) shall be paid.
Effective: July 15, 2016
History: Created 2016 Ky. Acts ch. 79, sec. 2, effective July 15, 2016.