Title 26 Insurance Code

26-52-105. Transparency; prohibitions.

(a) A pharmacy benefit manager or an agent of a pharmacy benefit manager shall not: (i) Cause or knowingly permit the use of an advertisement, promotion, solicitation, representation, proposal or offer that is untrue, deceptive or misleading; (ii) Charge a pharmacist or pharmacy provider a fee for any of the following: (A) The submission of a claim; (B) Enrollment or participation in a retail pharmacy network; (C) The development or management of claims processing services or claims payment services related to participation in a retail pharmacy network; (D) An application to apply for network access with the pharmacy benefit manager; (E) Credentialing or re-credentialing. (iii) Retroactively deny or reduce reimbursement for a covered pharmacy service or claim after adjudication of the claim, unless: (A) The original claim was fraudulent; or (B) The denial or reduction is necessary to correct errors found in an audit, provided that the audit was conducted in compliance with W.S. 26-52-103. (vii) Prohibit a pharmacy, pharmacy services administrative organization, contracting agent or agent of a pharmacy from sharing, upon request, copies of pharmacy benefit manager contracts with the department of insurance; (viii) Prohibit, restrict or limit disclosure of information to the insurance commissioner, law enforcement or other state or federal government officials who are investigating or examining a complaint or conducting a review of the pharmacy benefit manager's compliance with the requirements of this chapter. (c) Insurers, pharmacies and pharmacy benefit managers shall adhere to all state laws and rules when mailing or shipping prescription drugs into the state.