What is a PBM?
"Pharmacy benefit manager" or "PBM" means a person or entity doing business in this state that contracts with pharmacies on behalf of an insurer, third-party administrator,or managed care organization to administer prescription drug benefits to residents of this state. [See Idaho Code § 41-349(1)(b)].
When will the PBM law become effective?
July 1, 2020.
When do I have to register?
Registration must be completed annually, no later than April 1, of each year.
What year is the first year I am required to be registered?
2021, because it is the first year after the PBM law effective date that includes the due date to register of April 1.
Is there a cost to register as a PBM?
No fees are required to register at this time.
How do I register?
How do I renew my registration each year?
Complete and submit the PBM Registration Form, above, each year between January 1, and April 1.
What additional information is required to register?
The PBM Registration Form includes the mandatory information to register. If additional information is necessary, the Department will contact you.
I have a Third-Party Administrator (TPA) license/registration, do I also need a PBM registration, or vice-a-versa?
TPA and PBM are different types of authorization and you could require both. If your operating functions meet the definition of both a TPA and a PBM, yes, you will need both TPA and PBM authorizations to operate in Idaho. Please review the TPA requirements
I have more questions, who do I contact?
Technical Records Specialist II
If your question is not answered above, please submit your question directly to the DOI.