Nevada Code § 422.40523

Application to serve as state pharmacy benefit manager; requirements. [Effective on the effective date of the initial contract entered into between the Nevada Health Authority and the state pharmacy benefit manager pursuant to NRS 422.4053 , as amended by section 12 of chapter 390, Statutes of Nevada 2025, at page 2605 .]
Open in Lexace · Ask the AI about this section
1. A pharmacy benefit manager that meets
the eligibility requirements established pursuant to NRS 422.40527 may apply to become the
state pharmacy benefit manager by submitting an application to the Authority on
a form prescribed by the Authority. The application must include, without
limitation, disclosures of:
(a) Any activity, policy, practice, contract or
agreement of the applicant that may directly or indirectly present a conflict
of interest in the relationship between the applicant and the Authority or a
Medicaid managed care organization, including, without limitation, any such
activity, policy, practice, contract or agreement that operates solely or
partially outside this State;
(b) Any direct or indirect fees, charges or
assessments that the applicant imposes on any pharmacy in this State:
(1) With which the applicant shares common
ownership, management or control;
(2) Which is owned, managed or controlled
by any management, parent or subsidiary of the applicant, any company jointly
held by the applicant or any company otherwise affiliated with the applicant by
a common owner, manager or holding company;
(3) For which the board of directors of
the pharmacy shares any members in common with the board of directors of the
applicant; or
(4) Which shares any manager in common
with the applicant;
(c) All common ownership, common management,
common members of a board of directors, shared managers or shared control
between:
(1) The applicant, or any management,
parent, subsidiary or jointly held company of the applicant or any company
otherwise affiliated by a common owner, manager or holding company with the
applicant; and
(2) Any of the following entities:
(I) A Medicaid managed care
organization or a company affiliated with a Medicaid managed care organization;
(II) A pharmacy services
administrative organization, any other entity that contracts on behalf of a
pharmacy or any company affiliated with a pharmacy services administrative
organization or such an entity;
(III) A wholesaler, as defined in NRS 639.016 , or any company affiliated with
a wholesaler;
(IV) A third party, other than a
Medicaid managed care organization, or any company affiliated with such a third
party; and
(V) A pharmacy or any company
affiliated with a pharmacy; and
(d) All financial arrangements, including the
terms of each such arrangement, currently in effect between the applicant and a
manufacturer or labeler of prescription drugs, including without limitation, an
arrangement for:
(1) The management of a formulary;
(2) Fees relating to data sales; and
(3) Education and support for claims
processing.
2. As used in this section, third party
means any insurer or organization providing health coverage or benefits in
accordance with state or federal law.

‹ Prev All Nevada sections Next ›


Lexace provides legal information, not legal advice, and no attorney–client relationship is created. Statute text is provided for general information and may not reflect the most recent amendments; verify against the official state code.