™Your Policy Risk Impact Agent
284 chapters · 10,485 sections in this title.
Bus. & Prof. Code § 4430 Section 4430
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For purposes of this chapter, the following definitions shall apply: (a) “Carrier” means a health care service plan, as defined in Section 1345 of the Health and Safety Code, or a health insurer that issues policies of health insurance, as defined in Section 106 of the Insurance …
Bus. & Prof. Code § 4431 Section 4431
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(a) Nothing in this chapter shall apply to an audit conducted because a pharmacy benefit manager, carrier, health benefit plan sponsor, or other third-party payer has indications that support a reasonable suspicion that criminal wrongdoing, willful misrepresentation, fraud, or ab…
Bus. & Prof. Code § 4432 Section 4432
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Notwithstanding any other law, a contract that is issued, amended, or renewed on or after January 1, 2013, between a pharmacy and a carrier or a pharmacy benefit manager to provide pharmacy services to beneficiaries of a health benefit plan shall comply with the provisions of thi…
Bus. & Prof. Code § 4433 Section 4433
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(a) An entity conducting a pharmacy audit shall not receive payment or any other consideration on any basis that is tied to the amount claimed or actual amount recovered from the pharmacy that is the subject of the audit. Nothing in this subdivision shall be construed to prevent …
