§300gg–121. Oversight of entities that provide pharmacy benefit management services — Inbound Citations

Citations to 42 U.S.C. § 300gg–121 as a whole

• 42 U.S.C. § 300gg–22(a)(1)

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  (1) Subject to section 300gg–23¹ of this title, each State may require that health insurance issuers that issue, sell, renew, or offer health insurance coverage in the State in the individual or group market meet the requirements of this part and part D (other than section 300gg–121 of this title) with respect to such issuers.

• 42 U.S.C. § 300gg–22(a)(2)

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  (2) In the case of a determination by the Secretary that a State has failed to substantially enforce a provision (or provisions) in this part or part D (other than section 300gg–121 of this title) with respect to health insurance issuers in the State, the Secretary shall enforce such provision (or provisions) under subsection (b) insofar as they relate to the issuance, sale, renewal, and offering of health insurance coverage in connection with group health plans or individual health insurance coverage in such State.

• 42 U.S.C. § 300gg–22(b)(1)

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  (1) The provisions of this subsection shall apply to enforcement of a provision (or provisions) of this part or part D (other than section 300gg–121 of this title) only—

  (A) as provided under subsection (a)(2); and

  (B) with respect to individual health insurance coverage or group health plans that are non-Federal governmental plans.

• 42 U.S.C. § 300gg–22(b)(2)(A)

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  (A) Subject to the succeeding provisions of this subsection, any non-Federal governmental plan that is a group health plan and any health insurance issuer that fails to meet a provision of this part or part D (other than section 300gg–121 of this title) applicable to such plan or issuer is subject to a civil money penalty under this subsection.

• 42 U.S.C. § 300gg–22(b)(2)(C)(ii)

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  (ii) In determining the amount of any penalty to be assessed under this paragraph, the Secretary shall take into account the previous record of compliance of the entity being assessed with the applicable provisions of this part and part D (other than section 300gg–121 of this title) and the gravity of the violation.