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This entry was published on 2022-03-04
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SECTION 2907
Revocation or suspension of a registration or license of a pharmacy benefit manager
Insurance (ISC) CHAPTER 28, ARTICLE 29
§ 2907. Revocation or suspension of a registration or license of a
pharmacy benefit manager. (a) The superintendent may revoke, or may
suspend for a period the superintendent determines the registration or
license of any pharmacy benefit manager if, after notice and hearing,
the superintendent determines that the registrant or licensee or any
member, principal, officer, director, or controlling person of the
registrant or licensee, has:

(1) violated any insurance laws, section two hundred eighty-a of the
public health law or violated any regulation, subpoena or order of the
superintendent or of another state's insurance commissioner, or has
violated any law in the course of his or her dealings in such capacity
after such registration or license has been issued or renewed pursuant
to this article;

(2) provided materially incorrect, materially misleading, materially
incomplete or materially untrue information in the registration or
license application;

(3) obtained or attempted to obtain a registration or license through
misrepresentation or fraud;

(4)(A) used fraudulent, coercive or dishonest practices;

(B) demonstrated incompetence;

(C) demonstrated untrustworthiness; or

(D) demonstrated financial irresponsibility in the conduct of business
in this state or elsewhere;

(5) improperly withheld, misappropriated or converted any monies or
properties received in the course of business in this state or
elsewhere;

(6) intentionally misrepresented the terms of an actual or proposed
insurance contract;

(7) admitted or been found to have committed any insurance unfair
trade practice or fraud;

(8) had a pharmacy benefit manager registration or license, or its
equivalent, denied, suspended or revoked in any other state, province,
district or territory;

(9) failed to pay state income tax or comply with any administrative
or court order directing payment of state income tax; or

(10) ceased to meet the requirements for registration or licensure
under this article.

(b) Before revoking or suspending the registration or license of any
pharmacy benefit manager pursuant to the provisions of this article, the
superintendent shall give notice to the registrant or licensee and shall
hold, or cause to be held, a hearing not less than ten days after the
giving of such notice.

(c) If a registration or license pursuant to the provisions of this
article is revoked or suspended by the superintendent, then the
superintendent shall forthwith give notice to the registrant or
licensee.

(d) The revocation or suspension of any registration or license
pursuant to the provisions of this article shall terminate forthwith
such registration or license and the authority conferred thereby. For
good cause shown, the superintendent may delay the effective date of a
revocation or suspension to permit the registrant or licensee to satisfy
some or all of its contractual obligations to perform pharmacy benefit
management services in the state.

(e)(1) No individual, corporation, firm or association whose
registration or license as a pharmacy benefit manager has been revoked
pursuant to subsection (a) of this section, and no firm or association
of which such individual is a member, and no corporation of which such
individual is an officer or director, and no controlling person of the
registrant or licensee shall be entitled to obtain any registration or
license under the provisions of this article for a minimum period of one
year after such revocation, or, if such revocation be judicially
reviewed, for a minimum period of one year after the final determination
thereof affirming the action of the superintendent in revoking such
license.

(2) If any such registration or license held by a firm, association or
corporation be revoked, no member of such firm or association and no
officer or director of such corporation or any controlling person of the
registrant or licensee shall be entitled to obtain any registration or
license under this article for the same period of time, unless the
superintendent determines, after notice and hearing, that such member,
officer or director was not personally at fault in the matter on account
of which such registration or license was revoked.

(f) If any corporation, firm, association or person aggrieved shall
file with the superintendent a verified complaint setting forth facts
tending to show sufficient ground for the revocation or suspension of
any pharmacy benefit manager's registration or license, and the
superintendent finds the complaint credible, then the superintendent
shall, after notice and a hearing, determine whether such registration
or license shall be suspended or revoked.

(g) The superintendent shall retain the authority to enforce the
provisions of and impose any penalty or remedy authorized by this
chapter against any person or entity who is under investigation for or
charged with a violation of this chapter, even if the person's or
entity's registration or license has been surrendered, or has expired or
has lapsed by operation of law.

(h) A registrant or licensee subject to this article shall report to
the superintendent any administrative action taken against the
registrant or licensee in another jurisdiction or by another
governmental agency in this state within thirty days of the final
disposition of the matter. This report shall include a copy of the
order, consent to order or other relevant legal documents.

(i) Within thirty days of the initial pretrial hearing date, a
registrant or licensee subject to this article shall report to the
superintendent any criminal prosecution of the registrant or licensee
taken in any jurisdiction. The report shall include a copy of the
initial complaint filed, the order resulting from the hearing and any
other relevant legal documents.