Utah Code 31A-46-301. Reporting requirements
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(1) Before April 1 of each year, a pharmacy benefit manager operating in the state shall report to the department, for the previous calendar year:
Terms Used In Utah Code 31A-46-301
- Contract: A legal written agreement that becomes binding when signed.
- Contracting insurer: means an insurer with whom a pharmacy benefit manager contracts to provide a pharmacy benefit management service. See Utah Code 31A-46-102
- Department: means the Insurance Department. See Utah Code 31A-1-301
- 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.
- Insurer: means the same as that term is defined in Section 31A-22-636. See Utah Code 31A-46-102
- Pharmacist: means the same as that term is defined in Section 58-17b-102. See Utah Code 31A-46-102
- Pharmacy: means the same as that term is defined in Section 58-17b-102. See Utah Code 31A-46-102
- Pharmacy benefit manager: means a person licensed under this chapter to provide a pharmacy benefits management service. See Utah Code 31A-46-102
- State: when applied to the different parts of the United States, includes a state, district, or territory of the United States. See Utah Code 68-3-12.5
(1)(a) any insurer, pharmacy, or pharmacist in the state with which the pharmacy benefit manager had a contract;
(1)(b) the total value, in the aggregate, of all rebates and administrative fees that are attributable to enrollees of a contracting insurer; and
(1)(c) if applicable, the percentage of aggregate rebates that the pharmacy benefit manager retained under the pharmacy benefit manager’s agreement to provide pharmacy benefits management services to a contracting insurer.
(2) Records submitted to the commissioner under Subsections (1)(b) and (c) are a protected record under Title 63G, Chapter 2, Government Records Access and Management Act.
(3)
(3)(a) The department shall publish the information provided by a pharmacy benefit manager under Subsection (1)(c) in the annual report described in Section 31A-2-201.2.
(3)(b) The department may not publish information submitted under Subsection (1)(b) or (c) in a manner that:
(3)(b)(i) makes a specific submission from a contracting insurer or pharmacy benefit manager identifiable; or
(3)(b)(ii) is likely to disclose information that is a trade secret as defined in Section 13-24-2.
(3)(c) At least 30 days before the day on which the department publishes the data, the department shall provide a pharmacy benefit manager that submitted data under Subsection (1)(b) or (c) with:
(3)(c)(i) a general description of the data that will be published by the department;
(3)(c)(ii) an opportunity to submit to the department, within a reasonable period of time and in a manner established by the department by rule made in accordance with Title 63G, Chapter 3, Utah Administrative Rulemaking Act:
(3)(c)(ii)(A) any correction of errors, with supporting evidence and comments; and
(3)(c)(ii)(B) information that demonstrates that the publication of the data will violate Subsection (3)(b), with supporting evidence and comments.