What is a pharmacy benefits manager?

Section 38-71-2200 of the SC Code of Laws, as amended, defines a Pharmacy Benefit Manager as follows:

‘Pharmacy benefits manager’ means an entity that contracts with pharmacists or pharmacies on behalf of an insurer, third party administrator, or the South Carolina Public Employee Benefit Authority to:

       (a)   process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;

       (b)   pay pharmacies or pharmacists for prescription drugs or medical supplies; or

       (c)   negotiate rebates with manufacturers for drugs paid for or procured as described in this article.

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1. What is a pharmacy benefits manager?
2. What does the new South Carolina law do?
3. Will the Department promulgate new regulations?
4. My business is currently licensed as a Third Party Administrator (TPA). What do I need to do to become licensed as a PBM?
5. What happens if a PBM does not have a PBM license by January 1, 2021?
6. Is completion of the PBM Application Requirements Checklist required for PBM licensure?
7. How do I apply for a PBM license?
8. What happens when all requirements for PBM licensure are met?
9. Does a PBM need a TPA license in addition to a PBM license?
10. How can a PBM submit a name/address change?
11. How can I file a complaint with the Office of PBM Oversight?