N.Y. Insurance Law § 2907: Revocation or suspension of a registration or license of a pharmacy benefit manager

§ 2907. Revocation or suspension of a registration or license of a

pharmacy benefit manager. (a) The superintendent may revoke, or may

suspend for a period the superintendent determines the registration or

license of any pharmacy benefit manager if, after notice and hearing,

the superintendent determines that the registrant or licensee or any

member, principal, officer, director, or controlling person of the

registrant or licensee, has:

(1) violated any insurance laws, section two hundred eighty-a of the

public health law or violated any regulation, subpoena or order of the

superintendent or of another state's insurance commissioner, or has

violated any law in the course of his or her dealings in such capacity

after such registration or license has been issued or renewed pursuant

to this article;

(2) provided materially incorrect, materially misleading, materially

incomplete or materially untrue information in the registration or

license application;

(3) obtained or attempted to obtain a registration or license through

misrepresentation or fraud;

(4)(A) used fraudulent, coercive or dishonest practices;

(B) demonstrated incompetence;

(C) demonstrated untrustworthiness; or

(D) demonstrated financial irresponsibility in the conduct of business

in this state or elsewhere;

(5) improperly withheld, misappropriated or converted any monies or

properties received in the course of business in this state or

elsewhere;

(6) intentionally misrepresented the terms of an actual or proposed

insurance contract;

(7) admitted or been found to have committed any insurance unfair

trade practice or fraud;

(8) had a pharmacy benefit manager registration or license, or its

equivalent, denied, suspended or revoked in any other state, province,

district or territory;

(9) failed to pay state income tax or comply with any administrative

or court order directing payment of state income tax; or

(10) ceased to meet the requirements for registration or licensure

under this article.

(b) Before revoking or suspending the registration or license of any

pharmacy benefit manager pursuant to the provisions of this article, the

superintendent shall give notice to the registrant or licensee and shall

hold, or cause to be held, a hearing not less than ten days after the

giving of such notice.

(c) If a registration or license pursuant to the provisions of this

article is revoked or suspended by the superintendent, then the

superintendent shall forthwith give notice to the registrant or

licensee.

(d) The revocation or suspension of any registration or license

pursuant to the provisions of this article shall terminate forthwith

such registration or license and the authority conferred thereby. For

good cause shown, the superintendent may delay the effective date of a

revocation or suspension to permit the registrant or licensee to satisfy

some or all of its contractual obligations to perform pharmacy benefit

management services in the state.

(e)(1) No individual, corporation, firm or association whose

registration or license as a pharmacy benefit manager has been revoked

pursuant to subsection (a) of this section, and no firm or association

of which such individual is a member, and no corporation of which such

individual is an officer or director, and no controlling person of the

registrant or licensee shall be entitled to obtain any registration or

license under the provisions of this article for a minimum period of one

year after such revocation, or, if such revocation be judicially

reviewed, for a minimum period of one year after the final determination

thereof affirming the action of the superintendent in revoking such

license.

(2) If any such registration or license held by a firm, association or

corporation be revoked, no member of such firm or association and no

officer or director of such corporation or any controlling person of the

registrant or licensee shall be entitled to obtain any registration or

license under this article for the same period of time, unless the

superintendent determines, after notice and hearing, that such member,

officer or director was not personally at fault in the matter on account

of which such registration or license was revoked.

(f) If any corporation, firm, association or person aggrieved shall

file with the superintendent a verified complaint setting forth facts

tending to show sufficient ground for the revocation or suspension of

any pharmacy benefit manager's registration or license, and the

superintendent finds the complaint credible, then the superintendent

shall, after notice and a hearing, determine whether such registration

or license shall be suspended or revoked.

(g) The superintendent shall retain the authority to enforce the

provisions of and impose any penalty or remedy authorized by this

chapter against any person or entity who is under investigation for or

charged with a violation of this chapter, even if the person's or

entity's registration or license has been surrendered, or has expired or

has lapsed by operation of law.

(h) A registrant or licensee subject to this article shall report to

the superintendent any administrative action taken against the

registrant or licensee in another jurisdiction or by another

governmental agency in this state within thirty days of the final

disposition of the matter. This report shall include a copy of the

order, consent to order or other relevant legal documents.

(i) Within thirty days of the initial pretrial hearing date, a

registrant or licensee subject to this article shall report to the

superintendent any criminal prosecution of the registrant or licensee

taken in any jurisdiction. The report shall include a copy of the

initial complaint filed, the order resulting from the hearing and any

other relevant legal documents.