Regulators Propose Fines Against Pharmacy Benefits Managers

Auditor says Prime Therapeutics has operated without a license since 2013

By Justin Franz

HELENA — State regulators are proposing fines against two companies that manage pharmacy benefits for health insurers, saying they operated in Montana without a license.

Auditor and Insurance Commissioner Matt Rosendale said Wednesday the violations were discovered while the agency was gathering information for an interim legislative committee that was tasked with studying the reasons for the rising costs of prescription drugs.

Rosendale says Prime Therapeutics has operated without a license since 2013 and Express Scripts handled claims from 2013 to 2017 without a license. He says they also have not fully complied with requests for copies of contracts and pricing data sought by lawmakers.

The companies can ask for hearings on the licensure issue and the proposed fines, which could total up to $30,000 for each violation of the Montana Insurance Code.

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