Louisiana Administrative Code
Title 37 - INSURANCE Part
Part XIII - Regulations
Chapter 185 - Regulation Number 122-Roles and Responsibilities of Pharmacy Benefit Managers and Pharmacy Services Administrative Organizations
Section XIII-18507 - Roles and Responsibilities of Pharmacy Benefit Managers
Universal Citation: LA Admin Code XIII-18507
Current through Register Vol. 50, No. 9, September 20, 2024
A. The roles and responsibilities solely within the purview of pharmacy benefit managers are as follows:
1. administering prescription drug plans for
health plan sponsors;
2. formulary
and benefit design support and management;
3. establishing reimbursement rates and
making payments on behalf of health plan sponsors;
4. establishing and managing pharmacy
networks to ensure network adequacy on behalf of health plans;
5. performing drug utilization
management;
6. administering
disease management and drug adherence programs; and
7. negotiating rebates and discounts from
drug manufacturers.
AUTHORITY NOTE: Promulgated in accordance with R.S. 22:11, R.S. 22:1641(8), R.S. 22:1655, R.S. 22:1660.1(B)(1), R.S. 22:1660.8, R.S. 22:1660.9(C) and the Administrative Procedure Act, R.S. 49:950 et seq.
Disclaimer: These regulations may not be the most recent version. Louisiana may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
This site is protected by reCAPTCHA and the Google
Privacy Policy and
Terms of Service apply.
