PDF
Word
Form 440-5335 Pharmacy Benefit Manager Complaint: Maximum Allowable Cost (Mac) Appeal - Oregon
What Is Form 440-5335?
This is a legal form that was released by the Oregon Department of Consumer and Business Services - a government authority operating within Oregon. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form 440-5335?A: Form 440-5335 is a complaint form for Pharmacy Benefit Manager (PBM) related issues.
Q: What is a Pharmacy Benefit Manager (PBM)?A: A Pharmacy Benefit Manager (PBM) is a third-party administrator of prescription drug programs.
Q: What is a Maximum Allowable Cost (MAC) Appeal?A: A Maximum Allowable Cost (MAC) Appeal is a request to review the maximum price set by a PBM for certain generic drugs.
Q: What can I use Form 440-5335 for?A: You can use Form 440-5335 to file a complaint regarding Maximum Allowable Cost (MAC) Appeal issues with a PBM.
Q: Is Form 440-5335 specific to the state of Oregon?A: Yes, Form 440-5335 is specific to the state of Oregon.
Form Details:
- Released on October 1, 2017;
- The latest edition provided by the Oregon Department of Consumer and Business Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form 440-5335 by clicking the link below or browse more documents and templates provided by the Oregon Department of Consumer and Business Services.
Download Form 440-5335 Pharmacy Benefit Manager Complaint: Maximum Allowable Cost (Mac) Appeal - Oregon
1
2
