Section 27-45A-4

Licensure of pharmacy benefits managers.

(a) A person may not establish or operate as a pharmacy benefits manager in this state without first obtaining a license from the commissioner.

(b) Effective through December 31, 2021, to initially obtain a license or renew a license, a pharmacy benefits manager shall submit all of the following:

(1) A nonrefundable fee not to exceed five hundred dollars ($500).

(2) A copy of the licensee's corporate charter, articles of incorporation, or other charter document.

(3) A completed licensure form adopted by the commissioner containing:

a. The name and address of the licensee.

b. The name, address, and official position of an employee who will serve as the primary contact for the Department of Insurance.

c. Any additional contact information deemed appropriate by the commissioner or reasonably necessary to verify the information contained in the application.

(c) Not later than January 1, 2022, the commissioner shall adopt rules for licensure of pharmacy benefits managers to operate in this state. The rules shall establish all of the following:

(1) The licensing procedure and application form.

(2) Requirements for licensure.

(3) Reporting requirements.

(4) A fee schedule for a nonrefundable application fee and a nonrefundable license renewal fee, set to allow the regulation and oversight activities of the department to be self-supporting.

(d) On and after January 1, 2022, a person applying for a pharmacy benefits manager license shall submit an application for licensure in the form and manner prescribed by the commissioner by rule, along with the application fee.

(e) The commissioner may refuse to issue or renew a license if the commissioner determines that the applicant has been found to have violated this chapter or the insurance laws of this state or any other jurisdiction, or has had an insurance or other certificate of authority or license denied or revoked for cause by any jurisdiction.

(f) Unless denied licensure pursuant to subsection (e), a person who meets the requirements of this chapter and rules adopted by the commissioner shall be issued a pharmacy benefits manager license. The license may be in paper or electronic form and shall clearly indicate the expiration date of the license. Licenses are nontransferable. Notwithstanding any provision of law to the contrary, the application and license shall be public records.

(g) The license shall be initially renewed in accordance with a schedule prescribed by the commissioner and shall thereafter be subject to renewal on an annual basis along with the nonrefundable license renewal fee.

(h) A licensee shall inform the commissioner by any means acceptable to the commissioner of any material change in the information required by this section or rules adopted pursuant to this section within 30 days of the change. Failure to timely inform the commissioner of a change shall result in a penalty against the licensee in the amount of fifty dollars ($50).

(i) The commissioner may suspend or revoke a license or may impose civil penalties for a violation of this chapter or the insurance laws of this state or any other jurisdiction, as determined by the commissioner in accordance with rules adopted by the commissioner, provided a pharmacy benefits manager shall have the same rights as insurers to request a hearing in accordance with Sections 27-2-28, et seq. and to appeal as provided in Section 27-2-32.

(j) Unless surrendered, suspended, or revoked by the commissioner, a license issued under this section shall remain valid as long as the pharmacy benefits manager continues to do business in this state and remains in compliance with this chapter and applicable rules, including the payment of an annual license renewal fee as set forth in subsection (g).

(k) All documents, materials, or other information, and copies thereof, in the possession or control of the department that are obtained by or disclosed to the commissioner or any other person in the course of an application, examination, or investigation made pursuant to this chapter shall be confidential by law and privileged, shall not be subject to any open records, freedom of information, sunshine, or other public record disclosure laws, and shall not be subject to subpoena or discovery. This subdivision only applies to disclosure of confidential documents by the department and does not create any privilege in favor of any other party.

(l)(1) Fees collected pursuant to this section shall be deposited in the State Treasury to the credit of the Insurance Department Fund.

(2) Civil penalties collected pursuant to this chapter shall be deposited in the State Treasury to the credit of the state General Fund.

(m) Commencing January 1, 2022, a pharmacy benefits manager licensed by the commissioner prior to January 1, 2022, shall submit an application for a new license in accordance with subsection (d). The pharmacy benefits manager's previous license shall expire on the date the commissioner issues a new license or April 1, 2022, whichever occurs earlier.

(Act 2019-457, §4; Act 2021-341, §§1,4.)