PHARMACY BENEFIT MANAGERS

Per W.S. § 26-52-102 ↗, a pharmacy benefit manager is an entity that contracts with a pharmacy on behalf of an insurer or third party administrator to administer or manage prescription drug benefits.

Details regarding requirements of pharmacy benefit managers are outlined in W.S. § 26-52-101 ↗ et. seq.

LICENSING

No entity may act as a pharmacy benefit manager in Wyoming unless it first holds a license issued by the Wyoming Department of Insurance.

Applications for licensure may be made through Sircon ↗. The licensing fee is $500.

Licenses will renew annually on the last day of the month in which the license was issued. The license renewal fee is $500. 

Beginning July 1, 2022, documentation of pharmacy audit procedures and MAC list appeal procedures under W.S. § 26-52-103(a)(viii) ↗ and 26-52-104(e) ↗, respectively, will require disclosure in the license application. A new field will be added in Sircon for this purpose.