Compilation of Rules and Regulations of the State of Georgia
Department 120 - OFFICE OF COMMISSIONER OF INSURANCE, SAFETY FIRE COMMISSIONER AND INDUSTRIAL LOAN COMMISSIONER
Chapter 120-2 - RULES OF COMMISSIONER OF INSURANCE
Subject 120-2-97 - PHARMACY BENEFITS MANAGERS REGULATION
Rule 120-2-97-.06 - Examination by Commissioner; on-site visits; access to records; and expenses
Current through Rules and Regulations filed through September 23, 2024
(1) The Commissioner or his or her designated representative is authorized to conduct financial examinations, compliance audits, and investigate complaints of the affairs of each pharmacy benefits manager as often as is deemed necessary. Whenever the Commissioner shall deem it expedient, he or she shall examine, either directly or by use of an examiner duly authorized by him or her, the affairs, transactions, accounts, records, documents, assets, liabilities, of a pharmacy benefits manager and any other facts relative to its business methods, management, and dealings with a health plan or covered entity.
(2) Any pharmacy benefits manager being examined shall provide to the Commissioner or his or her designee convenient and free access, at all reasonable hours at their offices, to all books, records, documents and other papers relating to such pharmacy benefits manager's business affairs. In addition to on-site access to records, a pharmacy benefit manager shall, upon written request, make its records available to the Commissioner or the Commissioner's designee, unless otherwise directed by the Commissioner.
(3) A pharmacy benefits manager shall pay the fees and expenses of the examination whether conducted by the Commissioner or contracted examiner designated by the Commissioner. A consolidated account for the examination shall be filed by the examiner with the Commissioner. When a pharmacy benefits manager is examined as a result of a complaint filed against it and the Commissioner determines that the complaint was not justified, the expenses incurred as a result of the examination shall not be levied against the pharmacy benefits manager.
(4) Nothing in this rule shall limit or abridge any other investigatory powers of the Commissioner vested in him or her by Title 33 of the Official Code of Georgia Annotated.
O.C.G.A. §§ 33-2-9, 33-64-7.
