California Code of Regulations › Title 8 - Industrial Relations › Division 1 - Department of Industrial Relations › Chapter 4.5 - Division of Workers' Compensation › Subchapter 1 - Administrative Director-Administrative Rules › Article 5.5.2 - Medical Treatment Utilization Schedule › Section 9792.27.20 - Pharmacy and Therapeutics Committee - Conflict of Interest

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) The conflict of
					 interest standards are intended to ensure that the members of the P&T
					 Committee are free from financial interests or other relationships that could
					 compromise the objectivity of the members of the committee as they perform
					 their duties to consult with the Administrative Director on formulary updates
					 based upon the principles of evidence-based medicine. Appointed members of the
					 P&T Committee must impartially perform formulary update review activities,
					 and must be free of conflicts of interest.
(b) Persons applying to be appointed to the
					 P&T Committee shall not be employed by a pharmaceutical manufacturer, a
					 pharmacy benefits management company, or a company engaged in the development
					 of a pharmaceutical formulary for commercial sale, and shall not have been so
					 employed for 12 months prior to the appointment. A P&T Committee member who
					 undertakes such employment during the term of appointment shall not be eligible
					 to continue to serve on the committee.
(c) Members of the P&T Committee shall
					 not have a substantial financial conflict of interest in relation to a
					 pharmaceutical entity.
(1) "Pharmaceutical
					 entity" means a pharmaceutical manufacturer, pharmaceutical repackager,
					 pharmaceutical relabeler, compounding pharmacy, pharmacy benefits management
					 company, biotechnology company, or any other business entity that is involved
					 in manufacturing, packaging, selling or distribution of prescription or
					 non-prescription drugs, drug delivery systems, or biological agents.
(2) For purposes of this section,
					 "substantial financial conflict of interest" means that the applicant or
					 committee member, or his or her immediate family member, has a direct or
					 indirect financial interest in a pharmaceutical entity, including:
(A) Receipt of income within the previous 12
					 months, amounting to a total of $500 or more from the pharmaceutical entity,
					 including but not limited to salary, wages, speaking fees, consultant fees,
					 expert witness fees, honoraria, gifts, loans, and travel payments;
(B) Receipt of grants or research funding
					 from the pharmaceutical entity within the previous 24 months;
(C) Has had ownership interest in the
					 pharmaceutical entity at any time during the previous 12 months, including but
					 not limited to, a sole proprietorship, partnership, limited liability company,
					 or stock ownership in a corporation that is not publicly traded;
(D) Investment interest worth $2,000 or more
					 in a publicly-traded pharmaceutical entity, not including an investment held
					 through a diversified mutual fund;
(3) "Immediate family member" means spouse,
					 domestic partner, child, son-in-law, daughter-in-law, parent, mother-in-law,
					 father-in-law, brother or sister;
(4)
(A)
					 "Direct financial interest" means an interest held by the applicant or
					 committee member.
(B) "Indirect
					 financial interest" means an interest held by the applicant or committee
					 member's immediate family member, or held by a business entity or trust in
					 which the applicant or committee member owns directly or indirectly, or
					 beneficially, a 10-percent interest or greater.