2025 Vermont Statutes
Title 18 - Health
Chapter 77 - Pharmacy Benefit Managers
§ 3621. Insurer audit of pharmacy benefit manager activities

§ 3621. Insurer audit of pharmacy benefit manager activities

In order to enable periodic verification of pricing arrangements in administrative-services-only contracts, pharmacy benefit managers shall allow access, in accordance with rules adopted by the Commissioner, by the health insurer who is a party to the administrative-services-only contract to financial and contractual information necessary to conduct a complete and independent audit designed to verify the following:

(1) full pass-through of negotiated drug prices and fees associated with all drugs dispensed to beneficiaries of the health benefit plan in both retail and mail order settings or resulting from any of the pharmacy benefit management functions defined in the contract;

(2) full pass-through of all financial remuneration associated with all drugs dispensed to beneficiaries of the health benefit plan in both retail and mail order settings or resulting from any of the pharmacy benefit management functions defined in the contract; and

(3) any other verifications relating to the pricing arrangements and activities of the pharmacy benefit manager required by the contract if required by the Commissioner. (Added 2023, No. 127 (Adj. Sess.), § 1, eff. July 1, 2024.)