44-4605. License, required; application; fee; refusal to issue or renew; grounds; renewal; application; fee; failure to comply; fine; extension; notice of material change, required.

584 words·~3 min read·/ne/chapter-44/44-4605

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

(1)A person shall not establish or operate as a pharmacy benefit manager in this state for a health benefit plan without first obtaining a license from the director under the Pharmacy Benefit Manager Licensure and Regulation Act.

(2)The director may adopt and promulgate rules and regulations establishing the licensing application, financial, and reporting requirements for pharmacy benefit managers under the act.

(3)A person applying for a pharmacy benefit manager license shall submit an application for licensure in the form and manner prescribed by the director.

(4)A person submitting an application for a pharmacy benefit manager license shall include with the application a nonrefundable application fee. The director shall establish the nonrefundable application fee in an amount not to exceed five hundred dollars.

(5)The director may refuse to issue or renew a license if the director determines that the applicant or any individual responsible for the conduct of affairs of the applicant is not competent, trustworthy, financially responsible, or of good personal and business reputation, has been found to have violated 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.

(6)(a) Unless surrendered, suspended, or revoked by the director, a license issued under this section is valid as long as the pharmacy benefit manager continues to do business in this state and remains in compliance with the provisions of the act and any applicable rules and regulations, including the completion of a renewal application on a form prescribed by the director and payment of an annual license renewal fee. The director shall establish the annual license renewal fee in an amount not to exceed two hundred fifty dollars.

(b)Such application and renewal fee shall be received by the director on or before thirty days prior to the anniversary of the effective date of the pharmacy benefit manager's initial or most recent license.

(c)Subject to subdivision (6)(d) of this section, if a pharmacy benefit manager fails to comply with subdivision (6)(b) of this section:

(i)Such pharmacy benefit manager shall pay a fine of one hundred dollars for each day such failure continues and the pharmacy benefit manager continues to transact any business in this state; and

(ii)In addition to the fine required under subdivision (6)(c)(i) of this section, if the renewal application and fee are not received prior to the anniversary of the effective date of the pharmacy benefit manager's initial or most recent license, the pharmacy benefit manager's license shall be suspended until the pharmacy benefit manager has complied with subdivision (6)(b) of this section, any rules and regulations adopted and promulgated under this section, and any orders issued under this section. The director shall remit all such fines to the State Treasurer for distribution in accordance with Article VII, section 5, of the Constitution of Nebraska.

(d)For good and sufficient cause shown, the director may grant a reasonable extension of time not to exceed thirty days within which the renewal application and fee may be filed as required under subdivision (6)(b) of this section without the fine required under subdivision (6)(c)(i) of this section and without any suspension authorized under subdivision (6)(c)(ii) of this section.

(7)A pharmacy benefit manager shall immediately notify the director of any material change in its ownership or control or other fact or circumstance affecting its qualification for a license as a pharmacy benefit manager in this state.