The Louisiana Insurance Department (“Department”) recently fined Express Scripts Administrators, LLC (“ESA”) $275,000 and MedImpact Healthcare Systems, Inc. (“MedImpact”) $250,000 for allegedly failing to pay electronically...more
On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers...more
11/16/2023
/ Certificate of Authority ,
Florida ,
Health Insurance ,
Insurance Regulations ,
Licensing Rules ,
New Regulations ,
Pharmaceutical Industry ,
Pharmacies ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drug Coverage ,
Prescription Drugs ,
Regulatory Reform
Florida OIR Issues Informational Memorandum OIR-23-04M to PBMs -
On July 19, 2023, the Florida Office of Insurance Regulation (“OIR”) issued Informational Memorandum OIR-23-04M (“Memorandum”) to Pharmacy Benefit Managers...more
8/8/2023
/ Florida ,
Health Insurance ,
Healthcare ,
Insurance Claims ,
Insurance Regulations ,
Licensing Rules ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Regulatory Reform ,
Regulatory Requirements ,
TPAs
South Dakota -
The South Dakota Division of Insurance (“Division”) recently took regulatory action against a TPA that has held a valid TPA registration in South Dakota since 2006. In 2021, the TPA submitted its TPA...more
New York recently enacted legislation, SB 3762, requiring Pharmacy Benefit Managers (“PBMs”) doing business in New York to register and then become licensed with the New York Department of Financial Services (“DFS”). The law...more
4/27/2022
/ Covenant of Good Faith and Fair Dealing ,
Health Insurance ,
Healthcare ,
Healthcare Reform ,
New Legislation ,
New York ,
Pharmaceutical Industry ,
Pharmacy Benefit Manager (PBM) ,
Prescription Drugs ,
Regulatory Requirements ,
TPAs
In response to calls for greater transparency in the prescription drug industry, 2021 continued a nationwide trend of increased state licensing and regulation of Pharmacy Benefit Managers (“PBMs”). In the last year, laws...more
In response to calls for greater transparency in the prescription drug industry, 2019 continued a nationwide trend of increased state licensing and regulation of pharmacy benefit managers (“PBMs”). In the last year, laws...more
Polsinelli is pleased to share the June 2016 Third Party Administrator Newsletter. This newsletter covers topics throughout the year that impact TPAs. Information specific to Polsinelli's TPA practice is also included....more
7/11/2016
/ Filing Requirements ,
Health Insurance ,
Insurance Industry ,
Insurance Regulations ,
Licensing Rules ,
Medicaid ,
NAIC ,
Plan Administrators ,
Policies and Procedures ,
Prescription Drugs ,
Proposed Legislation ,
Registration Requirement ,
Service Agreements ,
Third-Party Agents
This past legislative session, several state legislatures enacted legislative regulating pharmacy benefit managers ("PBMs"). New Mexico, Utah, and Washington all adopted laws requiring licensure or registration of PBMs, in...more