Maine Code § 24-A-4350-C

Access to records; audits
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1. Requirements; record keeping. A carrier shall maintain and have the ability to access all data
related to the administration and provision of prescription drug benefits under a health plan of a carrier,
including, but not limited to:
A. The names, addresses, member identification numbers, protected health information and other
personal information of covered persons; and [PL 2019, c. 469, §8 (NEW); PL 2019, c. 469,
§9 (AFF).]
B. All contracts, documentation and records, including transaction and pricing data, related to the
dispensing of prescription drugs to covered persons under the health plan. [PL 2019, c. 469, §8
(NEW); PL 2019, c. 469, §9 (AFF).]
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]

2. Compliance with federal law. A sale or transaction involving the transfer of any records,
information or data described in subsection 1 must comply with the federal Health Insurance Portability
and Accountability Act of 1996, Public Law 104-191 and the federal Health Information Technology
for Economic and Clinical Health Act, Public Law 111-5 and any regulations adopted pursuant to those
laws.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
3. Audit records. A carrier may audit all transaction records related to the dispensing of
prescription drugs to covered persons under a health plan of the carrier. A carrier may conduct audits
at a location of its choosing and with an auditor of its choosing.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
4. Maintenance of records. A carrier shall maintain all records, information and data described
in subsection 1 and all audit records described in subsection 3 for a period of no less than 5 years.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]
5. Authority of superintendent. Upon request, a carrier shall provide to the superintendent any
records, contracts, documents or data held by the carrier or the carrier's pharmacy benefits manager for
inspection, examination or audit purposes.
[PL 2019, c. 469, §8 (NEW); PL 2019, c. 469, §9 (AFF).]

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