<html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-29E-7 - Annual audit of pharmacy benefit manager authorized.</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.sf20f2736de1b4119a9a38e3940d79af0Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.sf20f2736de1b4119a9a38e3940d79af0SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf20f2736de1b4119a9a38e3940d79af0CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2 { margin-left: 1.25in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1-000000 { margin-left: 1.25in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.sf20f2736de1b4119a9a38e3940d79af0000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.sf20f2736de1b4119a9a38e3940d79af0NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.sf20f2736de1b4119a9a38e3940d79af0SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-29E-7 - Annual audit of pharmacy benefit manager authorized."><meta property="og:description" content="SDLRC Codified Law 58-29E-7 - Annual audit of pharmacy benefit manager authorized."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-7"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="sf20f2736de1b4119a9a38e3940d79af0SENU">58-29E-7</span></a><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0SENU">. </span><span class="sf20f2736de1b4119a9a38e3940d79af0CL">Annual audit of pharmacy benefit manager authorized.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Statute"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">A third-party payor that has contracted with a licensed pharmacy benefit manager may audit the pharmacy benefit manager once each calendar year. The audit authorized by this section is in addition to any other statutory or contractual audit rights. As part of the audit, a third-party payor may request:</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(1)    All reimbursements paid to retail pharmacies, on a claim level, for all customers of the pharmacy benefit manager in this state, including ancillary charges, claw backs, dispensing fees, drug-specific reimbursements, other fees, rebates, and reimbursement adjustments;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(2)    Differences in reimbursement amounts paid to affiliated and unaffiliated pharmacies, including differences in dispensing fees and reimbursed ingredient costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(3)    Historical claims data, including:</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(a)    Acquisition costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1-000000"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(b)    Administrative fees associated with claims;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(c)    Amounts paid by a covered individual;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(d)    Amounts paid by a third-party payor;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(e)    Channels, whether mail or retail;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(f)    Dispensing fees;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(g)    Formulary tiers;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(h)    Ingredient costs;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(i)    Ingredient quantity;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(j)    Sales tax;</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(k)    Supply availability by the number of days; and</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber2"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(l)    Usual and customary prices; and</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0StatuteNumber1"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">(4)    Aggregate rebate amounts, received by calendar quarter, directly or indirectly from manufacturers, including rebates from other entities affiliated with or related to the pharmacy benefit manager, if those entities negotiate or contract with manufacturers.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Statute"><span class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont">A pharmacy benefit manager shall, within thirty days, provide the information requested in accordance with this section, together with a certification, signed by the chief executive officer or the chief financial officer of the pharmacy benefit manager, attesting to the accuracy and completeness of the information.</span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0Normal"><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0000001"> </span></p><p dir="ltr" class="sf20f2736de1b4119a9a38e3940d79af0NoIndent"><span xml:space="preserve" class="sf20f2736de1b4119a9a38e3940d79af0DefaultParagraphFont-000002">Source: </span><span class="sf20f2736de1b4119a9a38e3940d79af0SCL">SL 2004, ch 311, § 7; SL 2023, ch 166, § 7.</span></p></div></body></html><br /><hr><br /><html xmlns="http://www.w3.org/1999/xhtml" lang="en-US"><head><meta charset="UTF-8"><meta http-equiv='content-language' content='en-us'/><title>SDLRC - Codified Law 58-29E-7 - Annual audit of pharmacy benefit manager authorized.</title><meta name="Generator" content="PowerTools for Open XML"><style>span { white-space: pre-wrap; } p.s188c1165e6454b0fae13771c76826810Normal { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s188c1165e6454b0fae13771c76826810SENU { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s188c1165e6454b0fae13771c76826810CL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810Statute { text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s188c1165e6454b0fae13771c76826810DefaultParagraphFont { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810StatuteNumber1 { margin-left: 0.75in; text-indent: -0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } p.s188c1165e6454b0fae13771c76826810StatuteNumber1-000000 { margin-left: 0; text-indent: 0.50in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-right: 0; margin-bottom: .001pt; } span.s188c1165e6454b0fae13771c76826810000001 { font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } p.s188c1165e6454b0fae13771c76826810NoIndent { text-indent: 0.00in; text-align: justify; font-family: 'Times New Roman', 'serif'; font-size: 12pt; line-height: 108%; margin-top: 0; margin-left: 0; margin-right: 0; margin-bottom: .001pt; } span.s188c1165e6454b0fae13771c76826810DefaultParagraphFont-000002 { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: bold; margin: 0; padding: 0; } span.s188c1165e6454b0fae13771c76826810SCL { font-family: 'Times New Roman', 'serif'; font-size: 12pt; font-style: normal; font-weight: normal; margin: 0; padding: 0; } body { text-decoration-skip-ink: none; } </style><meta name="viewport" content="width=device-width, initial-scale=1"><meta name="twitter:card" content="summary"><meta property="og:title" content="SD 58-29E-7.1 - Prohibition on publication or disclosure of information."><meta property="og:description" content="SDLRC Codified Law 58-29E-7.1 - Prohibition on publication or disclosure of information."><meta property="og:type" content="website"><meta property="og:url" content="https://sdlegislature.gov/Statutes?Statute=58-29E-7.1"><meta property="og:image" content="https://lawmakerdocuments.blob.core.usgovcloudapi.net/photos/logoshape.webp"><meta property="og:site_name" content="South Dakota Legislature"></head><body><div><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Normal"><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7.1" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810SENU">58-29E-7.1</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810SENU">. </span><span class="s188c1165e6454b0fae13771c76826810CL">Prohibition on publication or disclosure of information.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Statute"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">Except as provided in chapter </span><a href="https://sdlegislature.gov/Statutes?Statute=58-17K" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-17K</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">, and in accordance with the audit provisions in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">, a third-party payor that has contracted with a licensed pharmacy benefit manager may not publish, or directly or indirectly disclose:</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(1)    Any information that reveals the identity of a specific third-party payor or manufacturer;</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(2)    Prices charged for a specific drug or class of drugs;</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(3)    The amount of any rebates provided for a specific drug or class of drugs; or</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">(4)    Any information that has the potential to compromise the financial, competitive, or proprietary nature of the pharmacy benefit manager's business.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810StatuteNumber1-000000"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">The information referenced in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont"> is protected from disclosure as confidential and proprietary. The information is privileged and not open to public inspection or disclosure.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Statute"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">A third-party payor that has contracted with a licensed pharmacy benefit manager shall impose the confidentiality protections set forth in § </span><a href="https://sdlegislature.gov/Statutes?Statute=58-29E-7" rel="noopener"><span class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont">58-29E-7</span></a><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont"> on any vendor or third party that may receive or have access to the information.</span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810Normal"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810000001"> </span></p><p dir="ltr" class="s188c1165e6454b0fae13771c76826810NoIndent"><span xml:space="preserve" class="s188c1165e6454b0fae13771c76826810DefaultParagraphFont-000002">Source: </span><span class="s188c1165e6454b0fae13771c76826810SCL">SL 2023, ch 166, § 8.</span></p></div></body></html>