KRS 304.9-053: Licensure of pharmacy benefit managers.

(1) (a) In order to conduct business in this state, a pharmacy benefit manager shall

first obtain a license from the commissioner. The license shall be in lieu of an

administrator's license as required by KRS 304.9-052.

(b) A licensed pharmacy benefit manager perf orming utilization review, as

defined in KRS 304.17A -600, shall be registered as a private review agent in

accordance with KRS 304.17A-607.

(2) (a) A person seeking a pharmacy benefit manager license shall apply to the

commissioner in writing on a form provided by the department.

(b) The application shall include:

1. The name, address, official position, and professional qualifications of

each individual responsible for the conduct of affairs of the pharmacy

benefit manager, including all members of the boa rd of directors, board

of trustees, executive committee, other governing board or committee,

the principal officers in the case of a corporation, the partners or

members in the case of a partnership or association, and any other

person who exercises contro l or influence over the affairs of the

pharmacy benefit manager; and

2. The name and address of the applicant's agent for service of process in

this state.

(3) Each application for a license, and subsequent renewal for a license, shall be

accompanied by:

(a) A nonrefundable fee of one thousand dollars ($1,000);

(b) Evidence of financial responsibility in an amount of one million dollars

($1,000,000); and

(c) Any methodologies utilized, or to be utilized, by the pharmacy benefit

manager in connection with reimbursement, which shall:

1. Comply with KRS 304.17A-595(2)(c); and

2. Be used in determining all appeals under KRS 304.17A-162.

(4) (a) All licenses issued under this section shall be renewed annually in accordance

with KRS 304.9-260.

(b) If the renewal fee required by subsection (3) of this section is paid after the

renewal date, a penalty fee of five hundred dollars ($500) shall be paid.