1.    A pharmacy benefits manager shall offer to a covered entity options for the covered entity to contract for services that must include:

Terms Used In North Dakota Code 26.1-27.1-05

  • Contract: A legal written agreement that becomes binding when signed.

a.    A transaction fee without a sharing of a payment received by the pharmacy benefits manager; b.    A combination of a transaction fee and a sharing of a payment received by the pharmacy benefits manager; or

c.    A transaction fee based on the covered entity receiving all the benefits of a payment received by the pharmacy benefits manager.

2.    The agreement between the pharmacy benefits manager and the covered entity must include a provision allowing the covered entity to have audited the pharmacy benefits manager’s books, accounts, and records, including de-identified utilization information, as necessary to confirm that the benefit of a payment received by the pharmacy benefits manager is being shared as required by the contract.