Rules & Regulations of the State of Tennessee
Title 0780 - Commerce and Insurance
Subtitle 0780-01 - Insurance Division
Chapter 0780-01-95 - Pharmacy Benefits Managers
Section 0780-01-95-.16 - VIOLATIONS; CONTROL OF PBM
Universal Citation: TN Comp Rules and Regs 0780-01-95-.16
Current through September 24, 2024
(1) The following acts are violations of this chapter:
(a) A PBM
fails to timely submit all information, including updates to information,
required pursuant to this chapter;
(b) A PBM provides any false, misleading, or
deceptive information to the Department;
(c) A PBM fails to comply with a requirement
of, or engages in any action prohibited by, this chapter; or
(d) Information submitted to the Department
indicates any of the following are not authorized to transact business in this
state; are not financially responsible as indicated by evidence of financial
negligence, financial fraud, or gross mismanagement; or have engaged in any
false, fraudulent, or dishonest practices in the course of business:
1. The PBM;
2. Any of the PBM's officers, directors,
partners, members, or managers; or
3. Any person or entity with control of a
PBM.
(2) A violation of this chapter may subject a PBM to the sanctions described in T.C.A. § 56-2-305.
(3) A person or entity that has, or that triggers a presumption of, control of a PBM may disclaim control in the same manner allowed under T.C.A. § 56-11-105(k).
Authority: T.C.A. §§ 56-2-305 and 56-7-3101.
Disclaimer: These regulations may not be the most recent version. Tennessee 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.
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