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Earlier editions: 2020-112018-112026-09

DIVISION 2. LICENSING PROVISIONS 1200-1796.88›CHAPTER 2.2. Health Care Service Plans 1340-1399.874›ARTICLE 6.1. Pharmacy Benefit Managers 1385.001-1385.009

§ 1385.0023

California Health and Safety Code · 2026-10 edition · updated 2026-10-04 · California

(a) The department may conduct periodic routine and nonroutine surveys of a pharmacy benefit manager. These surveys shall be conducted in accordance with Section 1380, as applicable.

(b) The department may conduct periodic routine and nonroutine examinations of the fiscal and administrative affairs of a pharmacy benefit manager. These examinations shall be conducted in accordance with Section 1382, as applicable.

(c) A complaint made by an enrollee that includes potential violations by a pharmacy benefit manager of the terms of this article shall be considered by the department to be a complaint against the health care service plan. A complaint made by an insured that includes potential violations by a pharmacy benefit manager of the terms of this article may be considered by the Department of Insurance to be a complaint against the insurer.

(Amended by Stats. 2025, Ch. 605, Sec. 7. (SB 41) Effective January 1, 2026.)

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