Ohio § 3957.09

§ 3957.09.

(A) Except as provided in division (G) of this section, no person shall act as a pharmacy

benefit manager on or after July 1, 2027, without first entering into a written agreement

with a plan sponsor. (B) The pharmacy benefit manager shall retain the written agreement as part of the pharmacy

benefit manager's official records for the duration of the agreement and for five

years thereafter.  Each agreement shall include, at a minimum, all of the following: (1) The term of the agreement; (2) An explanation of the services to be performed by the pharmacy benefit manager; (3) The method and rate of compensation to be paid by the plan sponsor to the pharmacy

benefit manager for services rendered; (4) Provisions for the renewal and termination of the agreement. (C) A pharmacy benefit manager shall maintain, for the duration of the agreement with

the plan sponsor, customary and relevant books and records of all transactions and

information relative to covered persons or beneficiaries.  The pharmacy benefit manager shall maintain such customary and relevant books and

records either electronically or in physical form at the pharmacy benefit manager's

principal office or branch office and shall make those books and records available

to the superintendent or the superintendent's designee at any time upon request.  Any protected health information received from the request shall be maintained in

compliance with all applicable federal and state privacy laws, including the “Health

Insurance Portability and Accountability Act of 1996,” 42 U.S.C. 1320d, et seq. and the regulations adopted under that act. (D) A pharmacy benefit manager shall account, annually or more frequently, to the plan

sponsor for any pricing discounts, rebates of any kind, inflationary payments, credits,

claw backs, fees, grants, charge backs, drug product reimbursements, or other benefits

received by the pharmacy benefit manager.  The pharmacy benefit manager shall give the plan sponsor access to all financial

and utilization information used by the pharmacy benefit manager in relation to pharmacy

benefit management services provided to the plan sponsor. (E) A pharmacy benefit manager shall disclose, in writing, to the plan sponsor the terms

and conditions of any contract or arrangement between the pharmacy benefit manager

and any other party relating to pharmacy benefit management services provided by the

pharmacy benefit manager to the plan sponsor, including pharmacy benefit management

services provided to group purchasing organizations. (F) A pharmacy benefit manager shall disclose, in writing, to the plan sponsor any activity,

policy, practice, contract, or arrangement of the pharmacy benefit manager that directly

or indirectly presents any conflict of interest concerning the pharmacy benefit manager's

relationship with or obligation to the plan sponsor. (G) Divisions (A) to (F) of this section apply to agreements subject to this chapter

and pharmacy benefit management services provided pursuant to those agreements.  Nothing in those divisions applies to pharmacy benefit management services provided

pursuant to an agreement that is not subject to this chapter. (H) A pharmacy benefit manager licensed under this chapter shall, at all times, maintain

any required insurance coverage or bond as provided for and mandated by the “Employee

Retirement and Income Security Act of 1974,” 29 U.S.C. 1001 .