H 4793 — Pharmacy Benefits Managers and Pharmacy Services Administrative Organizations

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17, 2025) - South Carolina Legislature Online South Carolina General Assembly126th Session, 2025-2026Bill 4793Indicates Matter StrickenIndicates New Matter(Text matches printed bills.

Document has been reformatted to meet World Wide Web specifications.)                 A bill   TO AMEND THE SOUTH CAROLINA CODE OF LAWS BY AMENDING SECTION 38-71-2250, RELATING TO EXAMINATIONS OF PHARMACY BENEFITS MANAGERs BOOKS AND RECORDS, SO AS TO PROVIDE THE EXAMINATIONS ARE SUBJECT TO THE REQUIREMENTS OF CHAPTER 13, TITLE 38;

AND BY AMENDING SECTION 38-71-2340, RELATING TO EXAMINATIONS OF PHARMACY SERVICES ADMINISTRATIVE ORGANIZATION BOOKS AND RECORDS, SO AS TO PROVIDE THE EXAMINATIONS ARE SUBJECT TO THE REQUIREMENTS OF CHAPTER 13, TITLE 38.

  Be it enacted by the General Assembly of the State of South Carolina:

  SECTION 1.  Section 38-71-2250(B) of the S.C.

Code is amended to read:

      (B)(1) As often as the director deems appropriate, but not less frequently than once every five years, the director may examine or audit the books and records of a pharmacy benefits manager providing claims processing services or other prescription drug or device services for a health benefit plan that are relevant to determining if the pharmacy benefits manager is in compliance with this actarticle.  Examinations conducted pursuant to this section are subject to the provisions of Chapter 13.

The pharmacy benefits manager shall pay the charges incurred in the examination, including the expenses of the director or his designee and the expenses and compensation of his examiners and assistants.  The director or his designee promptly shall institute a civil action to recover the expenses of examination against a pharmacy benefits manager which refuses or fails to pay.

       (2) The information or data acquired during an examination pursuant to this section is considered proprietary and confidential and is not subject to the South Carolina Freedom of Information Act.

  SECTION 2.  Section 38-71-2340(B) of the S.C.

Code is amended to read:

      (B)(1) As often as the director deems appropriate, but not less frequently than once every five years, the director may examine or audit the books and records of a pharmacy services administrative organization providing prescription drug coverage or benefits on behalf of pharmacies or pharmacy benefits managers that are relevant to determining if the pharmacy services administrative organization is in compliance with this actarticle.  Examinations conducted pursuant to this section are subject to the provisions of Chapter 13.

The pharmacy services administrative organization must pay the charges incurred in the examination, including the expenses of the director or his designee and the expenses and compensation of his examiners and assistants.  The director or his designee promptly must institute a civil action to recover the expenses of examination against a pharmacy services administrative organization which refuses or fails to pay.

       (2) The information or data acquired during an examination pursuant to this section is considered proprietary and confidential and is not subject to the South Carolina Freedom of Information Act.

  SECTION 3.  This act takes effect upon approval by the Governor.

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