Michigan Laws 550.840 – Enforcement of act; examination and audit
Current as of: 2023 | Check for updates
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Terms Used In Michigan Laws 550.840
- Claims processing services: means the administrative services performed in connection with the processing and adjudicating of claims relating to pharmacist services that include any of the following:
(i) Receiving payments for pharmacist services. See Michigan Laws 550.815Director: means the director of the department. See Michigan Laws 550.815 Freedom of Information Act: A federal law that mandates that all the records created and kept by federal agencies in the executive branch of government must be open for public inspection and copying. The only exceptions are those records that fall into one of nine exempted categories listed in the statute. Source: OCC Health plan: means a qualified health plan as that term is defined in section 1261 of the insurance code of 1956, 1956 PA 218, MCL 500. See Michigan Laws 550.815 Pharmacy: means that term as defined in section 17707 of the public health code, 1978 PA 368, MCL 333. See Michigan Laws 550.817 pharmacy benefit manager: means an entity that contracts with a pharmacy or a pharmacy services administration organization on behalf of a health plan or carrier to provide pharmacy health services to individuals covered by the health plan or carrier or administration that includes, but is not limited to, any of the following:
(i) Contracting directly or indirectly with pharmacies to provide drugs to enrollees or other covered persons. See Michigan Laws 550.817
(1) The director shall enforce this act.
(2) The director may examine or audit the relevant books and records of a pharmacy benefit manager providing claims processing services or other drug or device services for a health plan to determine if the pharmacy benefit manager is in compliance with this act.
(3) All of the following apply to information or data acquired during an examination under subsection (2), or otherwise acquired under this act:
(a) The information or data is considered proprietary and confidential.
(b) The information or data is not subject to the freedom of information act, 1976 PA 442, MCL 15.231 to 15.246.
(c) The information or data is only to be used for purposes of ensuring a pharmacy benefit manager’s compliance with this act.