An Act To Protect Consumers from Unfair Practices Related to Pharmacy Benefits Management
Maine Legislature, Session 129, LD 1504
Committee Amendment CA_B_S254 (Senate)
Amends: 22 MRSA §1711-E, 22 MRSA §8702, 24-A MRSA §601, 24-A MRSA §1913, 24-A MRSA §1913-A

COMMITTEE AMENDMENT "E " to S.P. 466, L.D. 1504, Bill, "An Act To 
Protect Consumers from Unfair Practices Related to Pharmacy Benefits Management" 
Amend the bill by striking out everything after the enacting clause and inserting the 
following: 
'Sec. 1. 22 MRSA §1711-E, sub-§1, 1G, as amended by PL 2011, c. 443, §1, is 
further amended to read: 
G. "Pharmacy benefits manager" has the same meaning as in Title 24-A, section 
~ 
1913-A, subsection 1. paragraph A •. 
Sec. 2. 22 MRSA §8702, sub-§8-B, as amended by PL 2011, c. 443, §3, is 
further amended to read: 
8-B. Pharmacy benefits manager. "Pharmacy benefits manager" has the same 
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meaning as in Title 24-A, section~ 1913-A, subsection 1. paragraph A. 
Sec. 3. 24-A MRSA §601, sub-§28, as enacted by PL 2009, c. 581, §3, is 
repealed. 
Sec. 4. 24-A MRSA §601, sub-§28-A is enacted to read: 
28-A; Pharmacy benefits manager. Pharmacy benefits manager licensing fees may 
not exceed: 
A. Original issuance fee, $100: and 
B. Renewal fee, $100. 
Sec. 5. 24-A MRSA §1913, as repealed and replaced by PL 2011, c. 443, §4, is 
repealed. 
Sec. 6. 24-A MRSA §1913-A is enacted to read: 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT" B" to S.P. 466, L.D. 1504 ( S -,Z9--~ 
§1913-A. Licensure of pharmacy benefits managers 
1. Definition; pharmacy benefits manager. As used in this section, "pharmacy 
benefits manager" means a person, business or other entity that, pursuant to a contract or 
under an employment relationship with a carrier, a self-insurance plan or other 3rd-party 
payer, either directly or through an intermediary, manages the prescription drug coverage 
provided by the carrier, self-insurance plan or other 3rd-party payer, including, but not 
limited to, processing and paying claims for prescription drugs, performing drug 
utilization review, processing drug prior authorization requests, adjudicating appeals or 
grievances related to prescription drug coverage, contracting with network pharmacies 
and controlling the cost of covered prescription drugs. 
2. 
License required. 
Beginning January 1, 2020, a person may not act as a 
pharmacy benefits manager in this State without first obtaining a license from the 
superintendent in accordance with this section and paying the licensing fee required under 
section 601, subsection 28-A. 
3. Applicant information. 
An applicant for licensure as a pharmacy benefits 
manager must file with the superintendent at least the following information: 
A. The name of the applicant; 
B. The address and telephone number of the applicant; 
C. The name and address of the applicant's agent for service of process in the State; 
D. The name and address of each person beneficially interested in the applicant; and 
E. 
The name and address of each person with management or control over the 
applicant. 
4. 
Oualiflcation. 
The superintendent may issue a pharmacy benefits manager 
license to an applicant only if the superintendent is satisfied that the applicant possesses 
· the necessary organization, expertise and financial integrity to supply the services sought 
to be offered. 
5. Restrictions permitted. The superintendent may issue a pharmacy benefits 
manager license subject to restrictions or limitations, including the type of services that 
. may be supplied or the activities in which the pharmacy benefits manager may engage. 
6. Valid for 3 years. A license issued pursuant to this section is valid for a period of 
years and must be renewed. 
7. Nontransferable. A license issued pursuant to this section is not transferable. 
8. 
Suspension, revocation or probationary license. 
The superintendent may 
suspend, revoke or place on probation a pharmacy benefits manager license under any of 
the following circumstances: 
A. The pharmacy benefits manager has engaged in fraudulent activity that constitutes 
7 
a violation of state or federal law; 
B. The superintendent has received consumer complaints that justify an action under 
this subsection to protect the safety and interests of consumers; 
COMMITTEE AMENDMENT 
COMMITTEE AMENDMENT "J.0 "to S.P. 466, L.D. 1504 ( 5 -2-5Lf1 
C. The pharmacy benefits manager fails to pay the original issuance or renewal fee 
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for the license; or 
D. The pharmacy benefits manager fails to comply with a requirement set forth in 
this section. 
9. Penalty for failure to obtain license. If a pharmacy benefits manager acts 
without obtaining a license pursuant to this section, the pharmacy benefits manager is 
subject to a fine of $5,000 per day for the period the pharmacy benefits manager is found 
to be in violation. 
· 
10. Rules. The superintendent may adopt routine technical rules pursuant to Title 5, 
chapter 375, subchapter 2-A to administer and enforce the requirements of this section. 
11. Enforcement. The superintendent may enforce this section under sections 220 
and 223 and other provisions of this Title. 
12. Registration remains effective until January 1, 2020 or registration date. 
The registration of a pharmacy benefits manager issued during 2019 in accordance with 
former section 1913 remains valid until January 1. 2020 or the next yearly anniversary of 
the registration date, whichever is later. 
Upon expiration of that registration. the 
pharmacy benefits manager shall obtain a license under this section in order to do 
business in this State.' 
SUMMARY 
This amendment is the minority report of the committee and replaces the bill. The 
amendment repeals the current registration requirement for pharmacy benefits managers 
and replaces it with a licensing requirement. 
FISCAL NOTE REQUJRED 
(See Attached) 
COMMITTEE AMENDMENT 
Approved: 05/29/19 wac. 
LD 1504 
LR382(03) 
An Act To Protect Consumers from Unfair Practices Related to Pharmacy Benefits Management 
Fiscal Note for Bill as Amended by Committee Amendment '/3" { 5, z.c;-L.,~ 
Committee: Health Coverage, Insurance and Financial SerVIces 
-
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor revenue increase - General Fund 
Minor revenue increase - Other Special Revenue Funds 
Correctional and Judicial Impact Statements 
The additional workload associated with the minimal number of new cases filed in the court system does not require 
additional funding at this time. 
The collection of additional fine revenue will increase General Fund and dedicated revenue by minor amounts. 
LR0382(03) - Fiscal Note - Page 1 of 1