Which of the following information regarding Pharmacy Benefit Prompt Pay Act is/are TRUE?
I. All benefits payable under a pharmacy benefit management plan shall be paid within 15 days after receipt of due written proof of a clean claim where claims are submitted electronically.
II. All benefits payable under a pharmacy benefit management plan shall be paid within 35 days after receipt of due written proof of a clean claim where claims are submitted in paper format.
III. Pharmacy benefit managers shall be required to update the amounts used for calculation of reimbursement for prescription drugs no less than every 3 business days.
a. I only
b. I and II only
c. II and III only
d. All
All, [Pharmacy Benefit Prompt Pay Act - Miss. Code Ann-73-21-155(2)(3)(a)].
1. Pharmacy benefit managers, their agents and other parties responsible for reimbursement for prescription drugs and other products and supplies shall be required to update the nationally recognized reference prices or amounts used for calculation of reimbursement for prescription drugs and other products and supplies no less than every three (3) business days.
2. All benefits payable under a pharmacy benefit management plan shall be paid within fifteen (15) days after receipt of due written proof of a clean claim where claims are submitted electronically, and shall be paid within thirty-five (35) days after receipt of due written proof of a clean claim where claims are submitted in paper format.
Benefits due under the plan and claims are overdue if not paid within fifteen (15) days or thirty-five (35) days, whichever is applicable, after the pharmacy benefit manager receives a clean claim containing necessary information essential for the pharmacy benefit manager to administer preexisting condition, coordination of benefits and subrogation provisions under the plan sponsor's health insurance plan.
3. A "clean claim" means a claim received by any pharmacy benefit manager for adjudication and which requires no further information, adjustment or alteration by the pharmacist or pharmacies or the insured in order to be processed and paid by the pharmacy benefit manager.