RS 22:1869
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/la/title-22/22-2648A research copy — for the controlling text, always check the official state or federal source. Not legal advice.
RS 22:1869
§1869. Compensation program; review by commissioner; exceptions
A. The commissioner may review the compensation program of a pharmacy benefit manager or person acting on behalf of a pharmacy benefit manager with a health insurance issuer, pharmacy services administrative organization, pharmacy, or pharmacist, or any person acting on their behalf, to ensure that the reimbursement for drugs, devices, and services paid to the pharmacist or pharmacy is fair and reasonable.
B. "Compensation program" means both of the following:
(1)Negotiated price concessions such as base price concessions, including those labeled as a rebate or otherwise; reasonable estimates of any price protection rebates; and performance-based price concessions that may accrue directly or indirectly to the health insurance issuer, plan, or other party on behalf of the health insurance issuer or plan, including a pharmacy benefit manager, during the coverage year. These concessions may come from a pharmaceutical manufacturer, dispensing pharmacy, or other party in connection with the dispensing or administration of a prescription drug.
(2)Reasonable estimates, as determined by the commissioner, of any negotiated price concessions, fees, and other administrative costs that are passed through, or are reasonably anticipated to be passed through, to the health insurance issuer or plan that serve to reduce the health insurance issuer's or plan's liabilities for a prescription drug.
C. Information provided to the commissioner pursuant to Subsection A of this Section and specifically identified as confidential by the pharmacy benefit manager, including the terms and conditions of any contract and other proprietary information, shall be confidential and shall not be subject to disclosure. However, the commissioner may disclose confidential information to insurance departments of other states or for the purposes of any adjudicatory hearing or court proceeding invoked by the commissioner in accordance with the provisions of this Part.
Acts 2025, No. 474, §1, eff. June 20, 2025.