Current through Register Vol. 46, No. 39, September 25, 2024
(a) Definitions.
(1) As used in this section, the terms
"controlling person", "health plan", "pharmacy benefit manager", "pharmacy
benefit management services" and "superintendent" have the same meanings as
defined by Public Health Law section 280-a.
(2) As used in this section, the term "a
substantial number of beneficiaries who work or reside in this state" means
where 50 percent or more of the beneficiaries of the health plan work or reside
in New York.
(b) A
pharmacy benefit manager applying for a registration prior to January 1, 2023
shall pay to the superintendent a non-refundable registration application fee
of $8,000. A pharmacy benefit manager applying for a registration on or after
January 1, 2023 shall pay to the superintendent a non-refundable registration
application fee of $4,000. Payment of the fee shall be made electronically in a
manner provided by the superintendent.
(c) Each entity seeking to register as a
pharmacy benefit manager shall electronically file with the department an
application on an electronic form and in a manner prescribed by the
superintendent to be published and made available on the department's publicly
accessible Internet website on or before June 1, 2022. Each pharmacy benefit
manager that submits an application on or before June 1, 2022, including
payment of the non-refundable registration application fee, shall be deemed to
hold a temporary registration valid until the department makes a determination
on the registration application.
(d) The application form for a pharmacy
benefit manager registration shall require the pharmacy benefit manager to
submit information to the department including:
(1) the name of the pharmacy benefit
manager.
(2) the address, contact
telephone number, and website for the pharmacy benefit manager;
(3) the federal employer identification
number for the pharmacy benefit manager;
(4) the name, address, email address and
telephone number of the primary contact person authorized to act on behalf of
the pharmacy benefit manager;
(5)
the name, address, email address and telephone number of the pharmacy benefit
manager's agent for service of process in this State;
(6) the name, position and email address of
each individual who is a controlling person of the pharmacy benefit manager,
including all members of the board of directors, board of trustees, executive
committee, or other governing board or committee; and (i) if the pharmacy
benefit manager is a partnership or other unincorporated association, each
partner or member; (ii) if the pharmacy benefit manager is a corporation, each
of its officers, and stockholders; (iii) if the pharmacy benefit manager is a
limited liability company, each officer, manager, or member;
(7) all basic organizational documents of the
pharmacy benefit manager, including any operating agreements, articles of
incorporation, articles of association, charter, partnership agreement, trade
name certificate, trust agreement, shareholder agreement, certificate of
existence from the New York Secretary of State and other applicable documents
and all amendments to such documents;
(8) the bylaws, rules, regulations or other
primary document regulating the internal affairs of the pharmacy benefit
manager;
(9) a copy of the pharmacy
benefit manager's standard, generic contract template, including provider
manual or other appropriate items incorporated by reference that the pharmacy
benefit manager uses for contracts entered into by the pharmacy benefit manager
with pharmacists, pharmacies or pharmacy service administration organizations
in New York in administration of pharmacy benefits for insurers; and
(10) such other information the
superintendent deems necessary.
(e) A pharmacy benefit manager shall notify
the department within 30 days of a change in any of the information disclosed
to the department on a registration application.
(f) The exemption provided for in 11 NYCRR
6.3 shall apply to filing under this section as if those filings were listed in
11 NYCRR 6.2(a).
