Prescription drug file--Required public disclosure--Method, format, and updates.

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58-17K-5. Prescription drug file--Required public disclosure--Method, format, and updates.

A health insurer shall make available to the public on a website a machine-readable prescription drug file that includes:

(1)A health insurance oversight identifier or employer identification number;

(2)The NDC and the proprietary and nonproprietary name assigned to the NDC by the Food and Drug Administration;

(3)A negotiated rate that is:

(a)Reflected as a dollar amount by an in-network provider, including an in-network pharmacy or other prescription drug dispenser;

(b)Associated with the national provider identifier, tax identification number, or place of service code; and

(c)Associated with the last date of the contract term; and

(4)Historical net prices that are:

(a)Reflected as a dollar amount by an in-network provider, including an in-network pharmacy or other prescription drug dispenser;

(b)Associated with the national provider identifier, tax identification number, or place of service code; and

(c)Associated with the ninety-day time period that begins one hundred eighty days prior to publication date of the machine-readable file for each provider-specific historical net price that applies to each NDC, unless a health insurer must omit data in relation to a particular NDC and provider when compliance with this subsection would require the health insurer to report payment of historical net prices calculated using fewer than twenty different claims for payments.

The prescription drug file shall be available in the method and format as promulgated by the director in rule pursuant to chapter 1-26. The prescription drug file shall be publicly available and accessible to any person free of charge and without conditions, including the establishment of a user account, password, or other credentials, or submission of personally identifiable information to access the file.

A health insurer shall update the prescription drug file monthly and indicate the date the file was most recently updated.

Source: SL 2021, ch 213, § 5.


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