Alternative Insurance

ORS 735.533
Denial, suspension or revocation of registration as pharmacy benefit manager

  • basis
  • complaint
  • rules


In accordance with ORS chapter 183, the Department of Consumer and Business Services may deny an application for registration as a pharmacy benefit manager or an application for renewal of a registration as a pharmacy benefit manager, and may suspend or revoke a registration as a pharmacy benefit manager, if the department finds that an applicant or registrant:


Falsified an application for registration or for the renewal of a registration or engaged in any dishonest act in relation to the application;


Engaged in dishonesty, fraud or gross negligence in the conduct of business as a pharmacy benefit manager;


Engaged in conduct that resulted in a conviction of a felony under the laws of any state or of the United States, to the extent that such conduct may be considered under ORS 670.280 (Denial, suspension or revocation of license based on criminal conviction);


Was convicted under the laws of any state or of the United States of any crime of which an essential element is dishonesty or fraud;


Had a certificate of authority or authority to conduct business as a pharmacy benefit manager denied, revoked or suspended in another state;


Failed to pay a civil penalty imposed by final order of the department or to comply with the terms of suspension set by the department;


Failed to meet the terms of a consent decree approved by a court of competent jurisdiction in this state, or a consent order made between the department and the pharmacy benefit manager;


Refused to be examined or to produce accounts, records or files for examination, including the refusal by any officer of the applicant or registrant to give information with respect to the affairs of the pharmacy benefit manager, or refused to perform any other legal obligation with respect to an examination by the department; or


Violated any rule or order of the department or any provision of the Insurance Code.


The department may prescribe by rule a procedure by which a pharmacy or an entity acting on behalf of a pharmacy may file a complaint with the department alleging that a pharmacy benefit manager has engaged in conduct described in this section. The department may restrict the right of a pharmacy or entity to file a complaint only to the extent necessary to prevent abuse of the complaint process. [2017 c.73 §2]
Note: See second note under 735.530 (Definitions for ORS 735.530 to 735.552).


Last accessed
Jun. 26, 2021