LAC 37:XIII.18507. Roles and Responsibilities of Pharmacy Benefit Managers

A. The roles and responsibilities solely within the purview of pharmacy benefit managers are as follows: 1. administering prescription drug plans for health plan sponsors; 2. formulary and benefit design support and management; 3. establishing reimbursement rates and making payments on behalf of health plan sponsors; 4. establishing and managing pharmacy networks to ensure network adequacy on behalf of health plans; 5. performing drug utilization management; 6. administering disease management and drug adherence programs; and 7. negotiating rebates and discounts from drug manufacturers.