{"data":{"id":"us-ky/krs-205.5518","jurisdiction":"us-ky","citation":"KRS 205.5518","heading":"Required and prohibited actions by pharmacy benefit manager -- Penalty","body":"for violation.\n(1) Notwithstanding any provisions of law to the contrary, beginning on March 27,\n2020, and continuing until December 31, 2020, a pharmacy benefit manager\ncontracted with a managed care organization to administer Medicaid benefits shall\nnot:\n(a) Adjust, modify, change, or amend reimbursement methodologies, dispensing\nfees, and any other fees paid by the pharmacy benefit manager to pharmacies\nlicensed in the Commonwealth;\n(b) Create, modify, implement, or indirectly establish any fee on a pharmacy,\npharmacist, or a Medicaid recipient in the Commonwealth; and\n(c) Make any adjustments, modifications, or changes to a pharmacy network for\nthe managed care organization  with whom the pharmacy benefit manager has\ncontracted to administer Medicaid benefits.\n(2) Notwithstanding any provisions of law to the contrary, beginning on March 27,\n2020, and continuing until December 31, 2020, a pharmacy benefit manager\ncontracted with a managed care organization to administer Medicaid benefits shall:\n(a) Administer, adjudicate, and, when appropriate, reimburse any pharmacy\nbenefit claim submitted to the managed care organization prior to the\ntermination of the contract between the ph armacy benefit manager and the\nmanaged care organization in accordance with the contract between the\npharmacy benefit manager and the managed care organization; and\n(b) Not be released from its obligation to make any payments owed to a pharmacy\nlicensed in  the Commonwealth for pharmacy services rendered prior to the\ntermination of the contract between the pharmacy benefit manager and the\nmanaged care organization.\n(3) The department shall impose a fine of twenty -five thousand dollars ($25,000) per\nday per s eparate violation on a pharmacy benefit manager who violates subsection\n(1) or (2) of this section.","path":["KRS Chapter 205"],"source_url":"https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=49888","current_through":"Includes enactments through the 2026 Regular Session","vintage":"09/05/2026","retrieved_at":"2026-09-05T20:52:03Z","sha256":"eb887784b5b94d04854e50ddc486b64dacf4b47b1b1edfec82e2b9cee53eb085","source_id":"us-ky","stale":false,"prev":"us-ky/krs-205.5516","next":"us-ky/krs-205.5520"},"notice":"GroundRules: Original legal text. Not legal advice."}