2018 Georgia Code
Title 33 - Insurance
Chapter 64 - Regulation and Licensure of Pharmacy Benefits Managers
§ 33-64-10. Administration of claims by pharmacy benefit manager
(a) When administering claims on behalf of group or blanket accident and sickness insurers subject to Chapter 30 of this title, a pharmacy benefits manager shall administer claims in compliance with Code Section 33-30-4.3 and shall not require insureds to use a mail-order pharmaceutical distributor including a mail-order pharmacy.
(b) Code Section 33-30-4.3 shall apply to individual accident and sickness policies issued pursuant to Chapter 29 of this title and, when administering claims on behalf of individual accident and sickness insurers subject to Chapter 29 of this title, a pharmacy benefits manager shall administer claims in compliance with Code Section 33-30-4.3 and shall not require insureds to use a mail-order pharmaceutical distributor including a mail-order pharmacy.
(c) This Code section shall not apply to:
(1) A care management organization, as defined in Chapter 21A of this title;
(2) The Department of Community Health, as defined in Chapter 2 of Title 31;
(3) The State Health Benefit Plan under Article 1 of Chapter 18 of Title 45; or
(4) Any licensed group model health maintenance organization with an exclusive medical group contract and which operates its own pharmacies licensed under Code Section 26-4-110.1.
