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Tenn. Code Ann. § 56-7-3107

Information to be provided regarding maximum allowable cost lists — Updating maximum allowable cost lists

Known as the Tennessee Insurance Law

The act spans §§ 56-10-101 to 56-8-206 (1,220 sections).

Acts 2014, ch. 857, § 2.

(1) A pharmacy benefits manager or covered entity shall make available to each pharmacy with which the pharmacy benefits manager or covered entity has a contract and to each pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, at the beginning of the term of a contract and upon renewal of a contract: The sources used to determine the maximum allowable costs for the drugs and medical products and devices on each maximum allowable cost list;

(2) Every maximum allowable cost for individual drugs used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy; and

(3) Upon request, every maximum allowable cost list used by that pharmacy benefits manager or covered entity for patients served by that contracted pharmacy.

(4) A pharmacy benefits manager or covered entity shall: Update each maximum allowable cost list at least every three (3) business days, as required by § 56-7-3104(b);

(5) Make the updated lists available to every pharmacy with which the pharmacy benefits manager or covered entity has a contract and to every pharmacy included in a network of pharmacies served by a pharmacy services administrative organization with which the pharmacy benefits manager or covered entity has a contract, in a readily accessible, secure and usable web-based format or other comparable format or process; and

(6) Utilize the updated maximum allowable costs to calculate the payments made to the contracted pharmacies within five (5) business days.

Current official text: Tennessee Code (LexisNexis). Digitized from the UniCourt Code Improvement Commission public-domain capture. Reproduced from public-domain Tennessee statutes; confirm against the official source for the current text. Not legal advice.