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Recent Regulatory Actions Against TPAs in South Dakota

The South Dakota Division of Insurance (“Division”) recently took regulatory action against a Texas-based Third Party Administrator (“TPA”) regarding its activities in South Dakota. According to the Division, the TPA...more

Louisiana Insurance Department Fines Express Scripts and Medimpact for Delayed Pharmacy Payments

The Louisiana Insurance Department (“Department”) recently fined Express Scripts Administrators, LLC (“ESA”) $275,000 and MedImpact Healthcare Systems, Inc. (“MedImpact”) $250,000 for allegedly failing to pay electronically...more

Florida Proposes New Pharmacy Benefit Manager Rules

On September 18, 2023, the Florida Office of Insurance Regulation (“OIR”) published proposed rules to implement provisions of the Prescription Drug Reform Act (Florida Senate Bill 1550) governing Pharmacy Benefit Managers...more

Louisiana Insurance Department Catastrophe Response Plans

The Louisiana Insurance Department (“Department”) recently sent e-mail notifications to numerous third party administrators (“TPA”) regarding the failure to file their Catastrophe Response Plans with the Department by June 1,...more

Third Party Administrator & Pharmacy Benefit Manager 2023 Newsletter: TPA & PBM Licensing And Compliance Developments

Florida OIR Issues Informational Memorandum OIR-23-04M to PBMs - On July 19, 2023, the Florida Office of Insurance Regulation (“OIR”) issued Informational Memorandum OIR-23-04M (“Memorandum”) to Pharmacy Benefit Managers...more

Third Party Administrator and Pharmacy Benefit Manager Licensing and Compliance Developments

South Dakota - The South Dakota Division of Insurance (“Division”) recently took regulatory action against a TPA that has held a valid TPA registration in South Dakota since 2006.  In 2021, the TPA submitted its TPA...more

Louisiana Insurance Department Issues Cease and Desist Orders to a TPA and the Louisiana Office of Group Benefits for Failure to...

The Louisiana Insurance Department (“Department”) recently issued separate Cease and Desist Orders to both a TPA operating as a Pharmacy Benefit Manager (“PBM”) and the Office of Group Benefits, a Louisiana state agency that...more

Louisiana Insurance Department Revises and Reissues Bulletin 07-01 Regarding Catastrophe Response Plans

The Louisiana Insurance Department (“Department”) recently revised and reissued Bulletin 07-01 to make all insurers, Health Maintenance Organizations (“HMO’s”)  and Third Party Administrators (“TPA”) and provided updated...more

Texas Regulatory Action a Significant Reminder that TPAs Must Operate Within the Scope of Their License

A third party administer administrator (“TPA”) based out of California recently entered into a Consent Order with the Texas Insurance Department (“Department”).  The Consent Order focused on the fact that the TPA had acted...more

Pharmacy Benefit Managers Licensing and Compliance Developments

In response to calls for greater transparency in the prescription drug industry, 2021 continued a nationwide trend of increased state licensing and regulation of Pharmacy Benefit Managers (“PBMs”). In the last year, laws...more

Third Party Administrator Newsletter - December 2021

New Law Regulating Health Care Benefit Managers in Washington State - We have previously reported on the new law that became effective this past summer in Washington requiring TPAs that administer self-funded workers’...more

New Law Regulating Health Care Benefit Managers in Washington State

We have previously reported on the new law that became effective this past summer in Washington requiring TPAs that administer self-funded workers compensation to become licensed with the Washington Department of Labor....more

Multistate Regulatory Action a Significant Reminder that Insurers Must Only Conduct Business with Licensed TPAs

A life and health insurer recently reached a settlement agreement with thirty-nine (39) state insurance departments following a targeted multistate market conduct examination (“Multistate Examination”). The Multistate...more

New TPA Law Governing Workers Compensation in Washington State

Washington has recently adopted legislation (Substitute House Bill 2409 that established Revised Code of Washington 51.14.179) that will impose new licensing and other regulatory requirements on workers compensation Third...more

Third Party Administrator Licensing and Compliance Services: Multistate Regulatory Action a Significant Reminder that Insurers...

A Regulatory Settlement Agreement was recently entered into by forty-one (41) states and an insurer as a result of a multistate targeted market conduct examination (“Multistate Examination”) of the insurer. The Multistate...more

Third Party Administrator Licensing and Compliance Services: North Carolina Regulatory Action a Reminder That Insurers Are...

The North Carolina Insurance Department (“Department”) recently announced a regulatory action against an insurer for alleged claims practices violations and contracting with a TPA before it became licensed in North Carolina....more

Third Party Administrator Licensing and Compliance Services: Recent Regulatory Actions Against TPAs

NEW JERSEY - The New Jersey Department of Banking and Insurance (“New Jersey Department”) recently took regulatory action against a TPA for untimely filing its annual report with the New Jersey Department....more

Recent Regulatory Actions Against TPAs (UPDATED)

The Kansas Insurance Department (“Kansas Department”) recently issued a Summary Order against a Missouri-domiciled third party administrator (“Company”) revoking the Company’s Kansas non-resident TPA license....more

Third Party Administrator (TPA) Licensing and Compliance Developments - January 2020

In response to calls for greater transparency in the prescription drug industry, 2019 continued a nationwide trend of increased state licensing and regulation of pharmacy benefit managers (“PBMs”). In the last year, laws...more

Third Party Administrator Newsletter - December 2019

Vermont Regulatory Action: A Reminder that Insurers Must Maintain Oversight of Their TPA and PBM Business Partners The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement...more

Vermont Regulatory Action: A Reminder that Insurers Must Maintain Oversight of their TPA and PBM Business Partners

The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement action against an insurer after determining that the insurer had violated various provisions of Vermont’s insurance laws,...more

Third Party Administrator (TPA) Licensing and Compliance Developments - November 2019

Hawaii Insurance Department Establishes TPA Application Requirements - Recently enacted Hawaii Senate Bill (SB) 1212 imposes extensive licensing and regulatory requirements on third party administrators (TPAs) operating in...more

Texas Insurance Department Issues Bulletin to TPAs and Agents

The Texas Insurance Department (TDI) recently issued Commissioners’ Bulletin No. B-0007-19 (the “Bulletin”) to Third Party Administrators (“TPAs”) and agents licensed in Texas. Specifically, the Bulletin is a reminder to TPAs...more

Third Party Administrator Update: TPA Licensing And Compliance Developments - June 2019

Hawaii Legislature Passes New TPA Law - Hawaii is expected to adopt legislation in the coming weeks that will impose licensing and other regulatory requirements on third party administrators (TPAs). Currently, Hawaii is one...more

Oregon Regulatory Action a Reminder That Insurers Cannot Outsource Their Regulatory Responsibilities

The Oregon Department of Consumer and Business Services (“Oregon Department”) recently announced it had entered into an Order to Cease and Desist, Final Order Assessing Civil Penalty and Consent to Entry of Order (“Order”)...more

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Updated: Dec 28, 2021:

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Information for EU and Swiss Residents

JD Supra's principal place of business is in the United States. By subscribing to our website, you expressly consent to your information being processed in the United States.

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Privacy Officer
JD Supra, LLC
150 Harbor Drive, #2760
Sausalito, CA 94965

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California Privacy Rights

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Privacy Officer
JD Supra, LLC
150 Harbor Drive, #2760
Sausalito, CA 94965

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Changes in Our Privacy Policy

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Contacting JD Supra

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Updates to This Policy

We may update this cookie policy and our Privacy Policy from time-to-time, particularly as technology changes. You can always check this page for the latest version. We may also notify you of changes to our privacy policy by email.

Contacting JD Supra

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