KRS 205.5518: Required and prohibited actions by pharmacy benefit manager -- Penalty

for violation.

(1) Notwithstanding any provisions of law to the contrary, beginning on March 27,

2020, and continuing until December 31, 2020, a pharmacy benefit manager

contracted with a managed care organization to administer Medicaid benefits shall

not:

(a) Adjust, modify, change, or amend reimbursement methodologies, dispensing

fees, and any other fees paid by the pharmacy benefit manager to pharmacies

licensed in the Commonwealth;

(b) Create, modify, implement, or indirectly establish any fee on a pharmacy,

pharmacist, or a Medicaid recipient in the Commonwealth; and

(c) Make any adjustments, modifications, or changes to a pharmacy network for

the managed care organization with whom the pharmacy benefit manager has

contracted to administer Medicaid benefits.

(2) Notwithstanding any provisions of law to the contrary, beginning on March 27,

2020, and continuing until December 31, 2020, a pharmacy benefit manager

contracted with a managed care organization to administer Medicaid benefits shall:

(a) Administer, adjudicate, and, when appropriate, reimburse any pharmacy

benefit claim submitted to the managed care organization prior to the

termination of the contract between the ph armacy benefit manager and the

managed care organization in accordance with the contract between the

pharmacy benefit manager and the managed care organization; and

(b) Not be released from its obligation to make any payments owed to a pharmacy

licensed in the Commonwealth for pharmacy services rendered prior to the

termination of the contract between the pharmacy benefit manager and the

managed care organization.

(3) The department shall impose a fine of twenty -five thousand dollars ($25,000) per

day per s eparate violation on a pharmacy benefit manager who violates subsection

(1) or (2) of this section.