Montana Code Annotated 2023

TITLE 33. INSURANCE AND INSURANCE COMPANIES

CHAPTER 2. REGULATION OF INSURANCE COMPANIES

Part 24. Pharmacy Benefit Manager Oversight

Pharmacy Benefit Manager Appeals Report

33-2-2408. Pharmacy benefit manager appeals report. (1) Pharmacy benefit managers shall track, monitor, and report to the commissioner each quarter the following aggregated information related to appeals filed pursuant to 33-22-173:

(a) the number of appeals filed by pharmacies;

(b) whether the appeals were denied or upheld by the pharmacy benefit manager and, if denied, the reasons for the denials;

(c) for each denial, confirmation that the pharmacy benefit manager provided the pharmacy in writing the pricing and other information required under 33-22-173;

(d) the total amount of price adjustments made by the pharmacy benefit manager; and

(e) the average amount of days taken to make price adjustments.

(2) The report must be filed within 30 days of the close of each calendar quarter.

(3) The commissioner may request information required under this section at any time if the commissioner believes the information is reasonably necessary to ensure compliance with this part, 33-22-170 through 33-22-177, and 33-22-180.

History: En. Sec. 8, Ch. 501, L. 2021.