§1185o. Oversight of entities that provide pharmacy benefit management services — Inbound Citations
29 U.S.C. § 1185o
Cited by 9 provisions in release 119-102.
Citations to 29 U.S.C. § 1185o as a whole
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(B) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, an entity providing pharmacy benefit management services, or an applicable entity (as defined in section 1185o(e) of this title) that knowingly provides false information under section 1185o of this title, in an amount not to exceed $100,000 for each item of false information. Such penalty shall be in addition to other penalties as may be prescribed by law.
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(C) The Secretary may waive penalties under subparagraph (A), or extend the period of time for compliance with a requirement of this section, for an entity in violation of section 1185o of this title that has made a good-faith effort to comply with the requirements of section 1185o of this title.
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(a) The requirements of this part (other than sections 1185 and 1185o of this title) shall not apply to any group health plan (and group health insurance coverage offered in connection with a group health plan) for any plan year if, on the first day of such plan year, such plan has less than 2 participants who are current employees.
Citations to §1185o(a)
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(A) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity (as defined in section 1185o(e) of this title) that violates section 1185o(a) of this title; an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under section 1185o(b) of this title; or any person who causes a group health plan to fail to provide the information required under section 1185o(c) of this title, in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported.
Citations to §1185o(b)
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(A) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity (as defined in section 1185o(e) of this title) that violates section 1185o(a) of this title; an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under section 1185o(b) of this title; or any person who causes a group health plan to fail to provide the information required under section 1185o(c) of this title, in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported.
Citations to §1185o(c)
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(A) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity (as defined in section 1185o(e) of this title) that violates section 1185o(a) of this title; an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under section 1185o(b) of this title; or any person who causes a group health plan to fail to provide the information required under section 1185o(c) of this title, in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported.
Citations to §1185o(e)
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(I) the terms “applicable entity” and “applicable group purchasing organization” have the meanings given such terms in section 1185o(e) of this title;
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(A) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, or an entity providing pharmacy benefit management services on behalf of such a plan or issuer, or an applicable entity (as defined in section 1185o(e) of this title) that violates section 1185o(a) of this title; an entity providing pharmacy benefit management services on behalf of such a plan or issuer that fails to provide the information required under section 1185o(b) of this title; or any person who causes a group health plan to fail to provide the information required under section 1185o(c) of this title, in the amount of $10,000 for each day during which such violation continues or such information is not disclosed or reported.
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(B) The Secretary may impose a penalty against a plan administrator of a group health plan, a health insurance issuer offering group health insurance coverage, an entity providing pharmacy benefit management services, or an applicable entity (as defined in section 1185o(e) of this title) that knowingly provides false information under section 1185o of this title, in an amount not to exceed $100,000 for each item of false information. Such penalty shall be in addition to other penalties as may be prescribed by law.