Standards of conduct — good faith — conflict of interest
2007 Acts, ch 193, §4, 9; 2022 Acts, ch 1113, §3, 16, 23; 2024 Acts, ch 1100, §2; 2025 Acts, ch 151, §2, 9
- 1. A pharmacy benefits manager shall exercise good faith and fair dealing in the performance of the pharmacy benefits manager’s contractual obligations toward a third-party payor or a pharmacy.
- 2. A pharmacy benefits manager shall notify a health carrier in writing of any activity, policy, practice ownership interest, or affiliation of the pharmacy benefits manager that presents any conflict of interest.
- 3. A pharmacy benefits manager shall act in the best interest of each third-party payor for whom the pharmacy benefits manager manages a prescription drug benefit provided by the third-party payor, and shall discharge its duties in accordance with applicable state and federal law.
- 4. A pharmacy benefits manager, health carrier, health benefit plan, or third-party payor shall not discriminate against a pharmacy or a pharmacist with respect to participation, referral, reimbursement of a covered service, or indemnification if a pharmacist is acting within the scope of the pharmacist’s license, as permitted under state law, and the pharmacy is operating in compliance with all applicable laws and rules.
Subsection 4 applies to pharmacy benefits managers, health carriers, third-party payors, and health benefit plans that manage a prescription drug benefit in the state on or after July 1, 2025; 2025 Acts, ch 151, §9 NEW subsection 4
2007 Acts, ch 193, §4, 9; 2022 Acts, ch 1113, §3, 16, 23; 2024 Acts, ch 1100, §2; 2025 Acts, ch 151, §2, 9